3.0T动态增强MRI定量参数、表观扩散系数与乳腺癌预后因子及分子分型的相关性  

Correlation Between Quantitative Parameters, Apparent Diffusion Coefficient of 3.0T Dynamic Enhanced MRI and Prognostic Factors as well as Molecular Types of Breast Cancer

作　　者：王倩[1] 刘万花[2] 王瑞[2] 叶媛媛[2] WANG Qian;LIU Wanhua;WANG Rui;YE Yuanyuan(Department of Radiology,Zhongda Hospital,Medical School,Southeast University,Nanjing 210009,China;不详)

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

出　　处：《中国医学影像学杂志》2019年第7期517-521,共5页Chinese Journal of Medical Imaging

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

摘　　要：目的分析定量动态增强MRI(DCE-MRI)参数和表观扩散系数(ADC)值与乳腺癌预后因子及分子分型的相关性。资料与方法回顾性分析127个获得病理及免疫组化检测结果的乳腺癌病灶。所有患者均同时行定量动态增强及扩散加权成像(b值取800 s/mm^2)扫描,所有病灶测量容量转移常数(K^trans)、速率常数(Kep)、血管外细胞外间隙容积比(Ve)及ADC值。根据人类表皮生长因子受体-2(HER-2)、孕激素受体(PR)、雌激素受体(ER)和Ki-67的表达情况对病灶进行分子分型。结果123个病灶纳入分子分型研究,其中Luminal A型24个、Luminal B型73个、HER-2过表达型15个和三阴性乳腺癌(TNBC)11个。ER、PR与K^trans、Kep、ADC值均呈负相关,其中ER与ADC值的相关性最大(r=-0.252,P=0.004),PR与K^trans值的相关性最大(r=-0.257,P=0.004);HER-2与Ve值及ADC值均呈正相关(r=0.187,P=0.037);Ki-67的表达率与K^trans呈正相关(r=0.226,P=0.012),而与Kep、Ve及ADC值均无相关性(P>0.05)。不同分子分型间K^trans值、Kep值、Ve值及ADC值差异均有统计学意义(P<0.05),Kep值诊断TNBC的受试者工作特征曲线下面积最大(0.904)。结论DCE-MRI定量参数及ADC值可在一定程度上预测分子分型,其中Kep值对TNBC的预测价值最高。Purpose To analyze the correlation between quantitative dynamic contrast enhanced MRI(DCE-MRI)parameters,apparent diffusion coefficient(ADC)and prognostic factors as well as molecular typing of breast cancer.Materials and Methods One hundred and twenty-seven focus of breast cancer with pathological and immunohistochemical results were retrospectively analyzed.Quantitative dynamic enhancement and DWI(b=800 s/mm^2)scanning were performed to all patients.Meanwhile,volume transfer constant(K^trans),rate constant(Kep),volume of EES per unit volume of tissue(Ve)value and ADC value of all focus were measured.Molecular typing of the focus was carried out according to expression status of human epidermal growth factor receptor 2(HER-2),progesterone receptor(PR),estrogen receptor(ER)and Ki-67.Results Among the 123 focus included in the study of molecular typing,24 were Luminal A,73 Luminal B,15 HER-2 over-expressed and 11 triple negative breast cancer(TNBC).ER and PR were negatively related to Ktrans,Kep and ADC value.Among,absolute value of correlation coefficient of ER and ADC value was the greatest(r=-0.252,P=0.004)and absolute value of correlation coefficient of PR and K^trans value was the greatest(r=-0.257,P=0.004).HER-2 and Ve value and ADC value was positively correlated(r=0.187,P=0.037).Expression rate of Ki-67 was positively related to K^trans(r=0.226,P=0.012).However,there was no correlation between expression rate of Ki-67 and Kep,Ve and ADC value(P>0.05).There was statistical significance regarding difference of K^trans,Kep,Ve and ADC value among different molecular typing(P<0.05).Area under curve of ROC of TNBC diagnosed by Kep was maximal(0.904).Conclusion DCE-MRI quantitative parameters and ADC value could predict molecular typing to a certain extent and among Kep value is of maximal predictive value to TNBC.

关 键 词：乳腺肿瘤 磁共振成像 表观扩散系数 图像增强 预后 病理学 外科 受体 erbB-2 受体 雌激素 受体 孕酮 KI-67抗原 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]