乳腺癌MR增强斜率与癌基因表达相关性研究  

Correlative Study Between Enhancement Slope and Oncogene Expression in Breast Cancer

作　　者：张延伟[1,2] 娄明武[3] 王芳军[1] 李园[1] 王晓春[1] 曾道辉[1] 冯欣[1] 李彩霞[1] 谢独[1] 

机构地区：[1]广州中医药大学第一附属医院影像科,广州510405 [2]广州中医药大学第三附属医院 [3]深圳市龙岗中心医院介入影像科,548116

出　　处：《临床放射学杂志》2012年第9期1247-1251,共5页Journal of Clinical Radiology

基　　金：广东省科技厅社会发展计划课题(编号:2010133)

摘　　要：目的观察分析乳腺癌增强斜率与癌基因表达的关系,探讨乳腺癌增强斜率大小的分子生物学基础,为临床治疗和预后判断提供新方法。方法对行MR动态增强扫描并经病理证实的58例乳腺癌患者的病理切片,行ER、PR及P53、CerbB-2、血管内皮生长因子(VEGF)及微血管密度(MVD)免疫组织化学检测,分析最大斜率与ER、PR及P53、CerbB-2、VEGF及MVD的相关性。结果 (1)增强扫描最大斜率与ER、PR呈负相关(r=-0.09,-0.17),与P53、CerbB-2的表达呈正相关(r=0.10,0.07),但均无统计学意义(P>0.05);(2)P53表达与ER、PR呈负相关(r=-0.26,-0.28),有统计学意义(P<0.05),提示P53高表达则预后不良;(3)MVD与VEGF表达呈正相关(r=0.39,P<0.05),动态增强扫描最大斜率与VEGF明显相关(r=0.63,P<0.01),但最大斜率与MVD无明显相关(r=0.08,P>0.05)。结论增强扫描最大斜率与VEGF表达有关,与MVD无明显相关性,提示恶性肿瘤斜率增高的分子生物学基础是血管内皮细胞不完整,通透性增加,而与血管密度无明显关系。临床上可根据增强扫描最大斜率的高低判断VEGF表达程度,从而判断预后并指导抗血管生成药物的选择,也可根据最大斜率的变化进行疗效判定。Objective To analyze the relationship between enhancement slope and oncogene expression in breast cancer, and to explore the molecular biology basis of enhancement slope and in order to provide a new method for clinical treatment and evaluating prognosis. Methods ER, PR, P53, CerbB 2, VEGF and MVD immunohistochemieal detection were performed in 58 patients with breast cancer confirmed by surgical pathology. All of them received MR dynamic enhance scanning. Results Enhancement maximum slope was negatively correlated with ER, PR, （ r = - 0.090, - 0. 169 re- spectively）, and positively correlated with P53, CerbB-2 expression respectively （r = 0. 099,0. 074）, but there were no statistical significant difference（ P 〉 0.05 ）. Negative correlation was existed between P53 expression and ER, PR（ r = -0. 257, -0.282）, which had a statistically significant difference（P 〈 0.05）, P53 high expression predicted a poor prognosis. MVD was positively correlated with VEGF expression（ r =0. 389, P 〈0.05 ）. Enhancement maximum slope was significantly related with VEGF maximum slope （ r = 0. 632 ,P 〈 0.01 ）, but with no obvious correlation between MVD and maximum slope （ r = 0. 079, P 〉 0.05）. Conclusion Enhancement maximum slope is related to ~EGF significantly, but no obvious correlations with MVD, which indicate the molecular biology of the malignant tumor is based on incomplete, increased vascular endothelial cells permeability without obvious relationship with vascular density. Enhancement maximum slope of lesions and expression degree of VEGF cAN be used to guide antiangiogenic drugs and evaluate effect of the therapy.

关 键 词：乳腺 新生物 磁共振成像 动态增强 癌基因 

分 类 号：R737.9[医药卫生—肿瘤]