3.0T磁共振不同b值表观扩散系数值与乳腺癌预后因子及分子分型相关性对比研究  

Correlation of apparent diffusion coefficient for different b values with prognostic factors and subtypes of breast carcinoma

作　　者：张悦[1] 刘万花[2] 王瑞[2] 叶媛媛[2] ZHANG Yue;LIU Wan-hua;WANG Rui;YE Yuan-yuan(Southeast University,Nanjing 210009,China;Department of Radiology,Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学,南京210009 [2]东南大学附属中大医院放射科,南京210009

出　　处：《磁共振成像》2018年第6期422-426,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家重点基础研究发展计划(973项目)(编号:2014CB744504)~~

摘　　要：目的对比分析3.0 T磁共振扩散加权成像(diffusion weighted imaging,DWI)不同b值下表观扩散系数(apparent diffusion coefficient,ADC)值与乳腺癌预后因子及分子分型的相关性。材料与方法 81例经手术病理证实为乳腺癌患者,于术前行不同b值(b=0、400、800、1000 s/mm2)DWI扫描,所有病灶行ADC值测量并计算平均值。利用免疫组织化学检测获得雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人类表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)及Ki-67的表达状态,并将其分为Luminal A型、Luminal B型、HER2过表达型及三阴性型4种分子亚型,其中Luminal B型又分为B1型和B2型。根据不同的数据资料分别采用独立样本t检验、单因素方差分析及Kruskal-Wallis检验进行统计分析。结果 (1)除b=400 s/mm^2时,ER分别表达阴阳性时的ADC值差异无统计学意义外,其余因子在不同b值下,不同表达状态的ADC值差异均具有统计学意义。(2)除b=400 s/mm2时,ADC值与ER阳性表达无相关性外,余不同b值下ADC值与ER、PR的阳性表达均呈负相关,与HER2阳性表达呈正相关,且当b=800、1000 s/mm^2时,各预后因子阳性表达与ADC值间相关系数较高;Ki-67表达程度与各b值下ADC值均无相关性。(3)在不同b值下,各分子分型间ADC值差异均有统计学意义(P<0.05);不同b值下Luminal A型及Luminal B型的ADC值间差异具有统计学意义(P<0.05),而HER2过表达型及三阴性型则差异无统计学意义(P均>0.05)。结论扩散加权成像ADC值与乳腺癌部分预后因子表达状态及不同分子亚型具有相关性,且行乳腺DWI检查时b值选择800 s/mm^2为佳。Objective:To investigate whether a correlation exists between apparent diffusion coefficient(ADC)obtained from magnetic resonance imaging diffusion weighted imaging(DWI)using different b values and different prognostic factors or immunohistochemical subtypes of breast cancers.Materials and Methods:The retrospective study included 81 patients with breast cancer.All patients were examined magnetic resonance imaging DWI using b values of 0,400,800 and 1000 s/mm^2 and apparent diffusion coefficient(ADC)values were measured.All the patients underwent the immunohistochemistry after the operation,and were divided into different subtypes based on the immunohistochemical profile.The associations between ADC values and prognostic factors and subtypes of breast cancers were evaluated by using the independent-samples t test and the one-way analysis of variance(ANOVA)and Kruskal-Wallis test.Results:(1)For different b values,there was a statistically significance in different state of expression of ER,PR and HER2,except ER for b=400 s/mm^2.(2)There was a positive correlation between ADC values for different b values and ER/PR positive,meanwhile it’s a negative correlation between ADC values for different b values and HER2 positive,except for b=400 s/mm^2.The correlation coefficient of ADC values for b=800 s/mm^2 and 1000 s/mm^2 are higher than b=400 s/mm^2.(3)For different b values,there was a statistically significance in ADC values between different immunohistochemical subtypes.There was a statistically significance for Luminal A and Luminal B between ADC values for different b values.Conclusions:The ADC value of DWI was correlated with the expression status of breast cancer prognosis factors and the subtypes of different molecules,and there is more significant correlation for high b values.

关 键 词：扩散加权成像 预后因子 分子分型 乳腺肿瘤 磁共振成像 表观扩散系数 

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]