乳腺癌患者X线和磁共振影像特点与ER/PR/HER2表达水平关系分析  

Analysis of the relationship between the characteristics of X-ray and MRI and the level of ER/PR/HER2 expression in breast cancer patients

作　　者：唐传姬 李萍[2] 周晓红 罗志珍 吴煌谊 ANG Chuanji;LI Ping;ZHOU Xiaohong;LUO Zhizhen;WU Huangyi(Medical Imaging Department,The 174th Hospotil of People's Liberation Army of China,Xiamen,Fujian 361003,China;Radiology Department,Dazhou Combine Traditional Chinese and Western Medicine Hospital,Dazhou,Sichuan 635000,China;Radiology Department,Leshan Hospital of Tradition Medicine,Leshan,Sichuan 614000,China;Pathology Department,Hunan Liuyang Maternity and Child Care Hospotil,Changsha,Hunan 410300,China;Department of Obstetrics and Gynecology,Maternity and Child Care Hospital of Jinjiang,Jinjiang,Fujian 362200,China)

机构地区：[1]中国人民解放军第一七四医院医学影像科,福建厦门361003 [2]达州市中西医结合医院放射科,四川达州635000 [3]乐山市中医院放射科,四川乐山614000 [4]湖南省浏阳市妇幼保健院病理科,长沙410300 [5]福建省晋江市妇幼保健院妇产科,福建晋江362200

出　　处：《国际检验医学杂志》2017年第24期3404-3407,共4页International Journal of Laboratory Medicine

摘　　要：目的探究乳腺癌患者X线、磁共振(MRI)影像特点与雌激素受体(ER)、孕激素受体(PR)、人类上皮因子受体2(HER2)表达水平的关系。方法选取2013年1月至2017年1月中国人民解放军第一七四医院、达州市中西医结合医院收治的108例乳腺癌患者作为研究对象,收集患者的临床、病理及影像学资料,所有患者入院后均完成X线、MRI检查,术后标本均行免疫组化染色检测癌细胞ER、PR、HER2表达情况。结果 ER表达阳性73例(67.59%),PR表达阳性63例(58.33%),HER2表达阳性43例(39.81%);合并钙化患者HER2阳性率高于未合并钙化者,差异有统计学意义(P<0.05);钙化灶沿导管走行患者PR阳性率低于不沿导管走行分布者,腺体或混合密度患者PR阳性率高于结构紊乱患者,钙化灶合并肿块、毛刺征、腺体或混合密度患者ER阳性率较高,差异有统计学意义(P<0.05);不同形态、不同形状、不同强化方式患者HER2阳性率有差异,且比较不同强化方式患者PR阳性率,差异有统计学意义(P<0.05);乳腺钼靶X线钙化征与HER2呈正相关,钙化沿导管走行与PR表达呈负相关,钙化合并肿块与ER呈正相关、PR呈负相关,毛刺征与ER呈正相关,结构紊乱与ER、PR呈负相关;MRI征象肿块型、不均匀强化与HER2呈负相关,形状不规则与HER2呈正相关,不均匀强化与PR呈正相关(r分别为0.363、-0.375、0.368、-0.326、0.426、-0.489、-0.373、-0.468、-0.403、0.391、0.425,P<0.05)。结论乳腺癌钼靶X线征象、MRI征象与ER、PR、HER2表达存在一定的相关性,其影像学改变可预测乳腺癌部分生物因子表达状况,与患者激素及化疗治疗敏感度及预后均存在一定关联。Objective To explore the relationship between the characteristics of Xray and magnetic resonance imaging(MRI)and the expression level of estrogen receptor(ER),progesterone receptor(PR)and human epithelial factor receptor2(HER2)in breast cancer patients.Methods108cases of breast cancer patients in the first74Hospital of the PLA from January2013to January2017were selected as the research object.Clinical,pathological and imaging data of patients were collected.All patients were examined by X-ray and MRI after admission.The expressions of ER,PR and HER2in cancer cells were detected by immunohistochemical staining.Results The expression of ER,PR and HER2was positive in73cases(67.59%),63cases(58.33%)and43cases(39.81%),respectively.The positive rate of HER2in patients with calcification was higher than that in patients without calcification(P<0.05).The positive rate of PR in patients with calcification along the duct was lower than that in patients of whom the calcification was not along the duct,and the positive rate of PR in patients with glandular or mixed density was higher than that in patients with structural disorder(P<0.05).The positive rate of ER was higher in patients with calcification,mass,spiculation signs,glandular or mixed density(P<0.05).There were significant differences in the positive rate of HER2between patients with different shapes and different enhancement modes(P<0.05),and there was a significant difference in the positive rate of PR between patients with different enhancement modes(P<0.05).Calcification displayed by X-ray mammography was positively correlated with HER2,calcification along the duct was negatively correlated with the expression of PR,calcification with mass was positively correlated with ER and negatively correlated with PR,spiculation sign was positively correlated with ER,and structural disorder was negatively correlated with ER and PR.Mass type and inhomogeneous enhancement of MRI signs were negatively correlated with HER2,irregular shape was positively correlated with HER2,

关 键 词：乳腺癌 磁共振 钼靶X线 雌激素受体 孕激素受体 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]