不同乳腺非特殊型浸润性癌分子分型的MRI表观扩散系数特点研究  

Apparent diffusion coefficient value study in different molecular subtypes of non-specific type invasive breast carcinomas

作　　者：南帅明 黄波[2] 罗娅红[1] NAN Shuaiming;HUANG Bo;LUO Yahong(Department of Radiology,Cancer Hospital of China Medical University,Liaoning Cancer Hospital & Institute,Shenyang 110042,China;Department of Pathology,Cancer Hospital of China Medical University,Liaoning Cancer Hospital & Institute,Shenyang 110042,China)

机构地区：[1]辽宁省肿瘤医院/中国医科大学肿瘤医院医学影像科,沈阳110042 [2]辽宁省肿瘤医院/中国医科大学肿瘤医院病理科,沈阳110042

出　　处：《磁共振成像》2019年第2期130-135,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家公益性行业专项基金(编号:201402020)~~

摘　　要：目的探讨乳腺非特殊型浸润性导管癌各分子亚型(Luminal A、Luminal B、HER-2过表达、基底细胞样型)及其生物学因子[雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、HER-2及Ki-67]的表观扩散系数(apparent diffusioncoefficient,ADC)是否具有一定的特征性,为鉴别不同分子亚型及评估乳腺癌预后提供理论依据。材料与方法回顾性分析术前行MRI检查的158例乳腺非特殊型浸润性癌患者的资料,术前获得扩散加权成像并测定平均ADC值,术后采用免疫组化检查获得ER、PR、HER-2及Ki-67等生物学因子和4种分子亚型。比较不同分子亚型间及乳腺癌生物学因子间的ADC值是否具有各自特征。结果 ER、PR、Ki-67阴性者的ADC值(1.013±0.099,1.002±0.094,1.003±0.087)高于阳性者(0.932±0.066,0.940±0.079,0.952±0.089),差异有统计学意义(P均<0.01);HER-2阳性者ADC值(1.004±0.088)显著高于阴性者(0.948±0.088),差异有统计学意义(P<0.05);HER-2过表达型的ADC值(1.048±0.073)较管腔B型及基底细胞样型(0.923±0.074,0.960±0.095)高,差异有统计学意义(P均<0.01)。结论乳腺非特殊型浸润性癌的各分子分型及生物学因子的ADC值具有一定的特征性。Objective: To investigate the characteristic of apparent diffusion coefficient (ADC) value in the four molecular subtypes of non-specific type invasive breast carcinomas (Luminal A, Luminal B, HER-2-enriched, Basal-like subtype) and its biological prognostic factors estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER-2) to provide the theory basis for identifying the different molecular subtypes and evaluating prognosis of breast cancer. Materials and Methods: One hundred and fifty-eight patients diagnosed as non-specific type invasive breast carcinomas with complete pathologic and preoperative MR data were retrospectively analyzed, preoperative diffusion weighted imaging were acquired (b=0, 800 s/mm2), the average ADC was measured;ER, PR, HER-2 and Ki-67 were obtained by immunohistochemistry, and the subtype of each case was decided. To investigate the characteristic of the ADC values in molecular subtypes and its biological prognostic factor. Results: ADC value of ER-negative, PR negative group and Ki-67 negative group was higher than that in ER-positive and PR-positive group and Ki-67 positive group (1.013±0.099, 1.002±0.094, 1.003±0.087 VS 0.932±0.066, 0.940±0.079, 0.952±0.089), the difference was statistically significant (P<0.01, P<0.01);ADC value of HER-2 positive group is significantly higher than that in HER-2 group negative (1.004±0.088 VS 0.948±0.088), the difference was statistically significant (P<0.05);while only the ADC values of HER-2-enriched subtype was higher than Luminal B and Basal-like subtype (1.048±0.073 VS 0.923±0.074, 0.960±0.095, P< 0.01, P<0.01). Conclusions: The four molecular subtypes and its biological prognostic factors present characteristic ADC value in non-specific type invasive breast carcinomas.

关 键 词：乳腺肿瘤 磁共振成像 表观扩散系数 分子分型 生物学因子 

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]