摘要
目的 探讨临床病理特征和MRI特征在乳腺癌易感基因(breast cancer susceptibility gene, BRCA)基因突变与非突变型乳腺癌患者中的差异。材料与方法 回顾性分析2011年6月至2017年7月在复旦大学附属肿瘤医院确诊手术并经二代测序确定BRCA基因状态的81名BRCA基因非突变型和76例BRCA基因突变型乳腺癌患者(包括BRCA1基因突变38例,BRCA2基因突变38例)的临床病理资料、活检前MRI扫描图像和预后资料。采用卡方检验、Fisher’s精确检验和多因素logistic回归分析BRCA基因突变型与非突变型、BRCA1突变型和BRCA2突变型乳腺癌之间临床病理特征及MRI特征的差异。结果 在BRCA基因突变组和非突变型乳腺癌之间,组织学类型的分布差异具有统计学意义(P=0.037)。BRCA基因突变乳腺癌组织学类型为浸润性导管癌(invasive ductal carcinoma, IDC)的比例较高,BRCA1基因和BRCA2基因突变乳腺癌中表现为IDC的比例分别为92.11%和94.74%。单因素分析中,BRCA非突变型乳腺癌更多表现为流入(Ⅰ型)或平台型(Ⅱ型)而非廓清型(Ⅲ型)强化曲线(P=0.041)。BRCA1基因突变乳腺癌和BRCA2基因突变乳腺癌患者间肿块型病灶分布差异具有统计学意义(P=0.030),BRCA2基因突变的病灶表现为不规则形的比例较高,占表现为肿块型的BRCA2基因突变病灶的87.10%。纤维腺体组成和BPE特征在BRCA基因突变和非突变乳腺癌之间差异无统计学意义。结论 BRCA基因突变型和非突变型乳腺癌的组织学类型、分子分型和Ki-67指数存在显著差异,MRI中的病灶形态和强化曲线在单因素分析中也与BRCA基因状态有关。
Objective:To investigate the relationship between MRI clinicopathological features and breast cancer susceptibility gene(BRCA)gene mutation in breast cancer.Materials and Methods:Retrospective collection clinicopathological,MRI and prognosis data of 81 BRCA gene non-mutant breast cancer and 76 BRCA gene mutant breast cancer patients(including 38 BRCA1 gene mutation and 38 BRCA2 gene mutation)diagnosed and detected BRCA gene status by next generation sequencing technology in Fudan University Shanghai Cancer Center from June 2011 to July 2017.Chi-square test,Fisher's exact test and multivariate logistic regression were used to analyze the differences of clinicopathologic and MRI features between BRCA gene mutant and non-mutant,BRCA1 gene mutant and BRCA2 gene mutant breast cancer patients.Results:There was a statistically significant difference in the distribution of histological types between BRCA gene mutation group and non-mutant breast cancer(P=0.037).The proportion of BRCA-mutated breast cancer with invasive ductal carcinoma(IDC)was high,and the proportion of BRCA1 and BRCA2 mutated breast cancer with IDC was 92.11%and 94.74%,respectively.In univariate analysis,BRCA non-mutant breast cancer was more performed as I+Ⅱother than typeⅢenhancement curve(P=0.041).There was a statistically significant difference in the distribution of mass lesions between BRCA1 gene mutation breast cancer and BRCA2 gene mutation breast cancer(P=0.030).The proportion of BRCA2 gene mutation lesions showing irregular shape was higher,accounting for 87.10%of BRCA2 gene mutation lesions showing mass type.There was no significant difference in fibroglandular composition and BPE characteristics between BRCA mutated and non-mutated breast cancer.Conclusions:Histology,molecular subtype and Ki-67 index were different in BRCA mutant and non-mutant breast cancer.Lesion type and enhancement curve type on MRI were also associated with BRCA gene status in univariate analysis.
作者
蔺璐奕
王泽洲
肖勤
胡震
顾雅佳
尤超
LIN Luyi;WANG Zezhou;XIAO Qin;HU Zhen;GU Yajia;YOU Chao(Department of Radiology,Fudan University Shanghai Cancer Center,Shanghai 200032,China;Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Cancer Prevention,Fudan University Shanghai Cancer Center,Shanghai 200032,China;Department of Breast Surgery,Fudan University Shanghai Cancer Center,Shanghai,200032,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2024年第1期21-27,共7页
Chinese Journal of Magnetic Resonance Imaging
基金
上海“科技创新行动”计划医学创新研究专项(编号:21Y11910200)
国家癌症中心攀登基金重点项目(编号:NCC201909B06)。
关键词
乳腺癌
BRCA基因突变
鉴别
病灶形态特征
强化曲线
磁共振成像
breast cancer
BRCA gene mutation
distinguish
morphological characteristics of the lesions
enhancement curve
magnetic resonance imaging
