MRI乳腺背景实质强化与乳腺癌分子亚型的相关性研究  

Study on the Correlation between Background Enhancement of Breast and Molecular Subtypes of Breast Cancer on Magnetic Resonance Imaging

作　　者：朱娟[1] 朱宜春[1] ZHU Juan;ZHU Yichun(Anqing Municipal Hospital,Anhui Anqing 246003,China)

机构地区：[1]安徽省安庆市立医院核磁共振室

出　　处：《河北医学》2019年第9期1571-1576,共6页Hebei Medicine

基　　金：安徽医科大学科研基金项目,(编号:2015xkj071)

摘　　要：目的:探讨BPE(Background parenchymal enhancement,乳腺背景实质强化)与乳腺癌分子亚型及常见预后相关标志物的相关性。方法:回顾性分析2017年1月至2018年4月本院经乳腺MRI检查的60例女性患者的临床资料。患者均经美国GE MR750 3.0T超导磁共振扫描系统检查,具有完整的MRI动态增强图像结果。患者均接受免疫组化指标检测,包括: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,HER-2)和Ki-67指数。分析病理结果及分子亚型结果,考察BPE、FGT与分子亚型及预后标志物的相关性。结果:60例乳腺癌的病理分型:浸润性导管癌54例、导管内乳头状癌2例、导管原位癌4例。分子亚型:Luminal A型19例、Luminal B型26例、HER-2过表达型12例、TNBC 3例。BPE、FGT:BPE的分布为BPE 1(14,23.3%)、BPE 2(27,45%)、BPE 3(12,20%)及BPE 4(7,11.7%),FGT的分布为FGT 1(2,3.4%)、FGT 2(15,25%)、FGT 3(23,38.3%)级FGT 4(20,33.3%)。高BPE和FGT组的患者平均年龄低于低BPE和FGT组,差异均具有统计学意义(t分别为3.8、2.5,P分别为0.008、0.01)。Ki-67指数平均值与高、低组别BPE和FGT无显著关联(t分别为6.1、5.8,P分别为0.45、0.43)。相关性分析结果:Luminal B型、HER-2过表达型乳腺癌及TNBC与Luminal A型乳腺癌相比,高BPE及FGT均无相关性(P均>0.05)。在月经状态比较中,绝经前患者的BPE和FGT比绝经后患者的BPE和FGT更高,差异具有统计学意义(χ2分别为20.5、18.23,P分别为0.007、0.004),在其他预后标志物中,高BPE与淋巴结状态、组织学分级及Ki-67表达均没有显著相关性(P均>0.05)。结论:部分预后较差如HER-2过表达型乳腺癌或TNBC,高BPE并不增加其风险。BPE升高与腋窝淋巴结阳性、Ki-67指数高表达、高组织学分级等预后不良标志物无明显相关性。Objective:To investigate the correlation between BPE(Background parenchymal enhancement)and molecular subtypes and common prognostic markers of breast cancer.Methods:A retrospective analysis was made on the clinical data of 60 female patients examined by breast MRI in our hospital from January 2017 to April 2018.All patients were examined by GE MR750 3.0T superconducting magnetic resonance scanning system in the United States,and had complete dynamic enhanced image results.All patients received immunohistochemical tests,including estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER-2)and Ki-67 index.Pathological and molecular subtype results were analyzed to investigate the correlation between BPE,FGT and molecular subtypes and prognostic markers.Results:60 cases of breast cancer were classified as invasive ductal carcinoma in 54 cases,intraductal papillary carcinoma in 2 cases and ductal carcinoma in situ in 4 cases.Molecular subtypes:19 cases of Luminal A,26 cases of Luminal B,12 cases of HER-2 overexpression and 3 cases of TNBC.The distribution of BPE and FGT:BPE was BPE 1(14,23.3%),BPE 2(27,45%),BPE 3(12,20%)and BPE 4(7,11.7%).The distribution of FGT was FGT 1(2,3.4%),FGT 2(15,25%)and FGT 3(23,38.3%)FGT 4(20,33.3%).The average age of patients with high BPE and FGT was lower than that of patients with low BPE and FGT,and the difference was statistically significant(t value was 3.8,2.5,P value was 0.008 and 0.01,respectively).The average Ki-67 index was not significantly correlated with BPE and FGT in high and low groups(t value was 6.1,5.8,P value was 0.45 and 0.43,respectively).The results of correlation analysis showed that there was no correlation between high BPE and FGT in Luminal B,HER-2 overexpression breast cancer and TNBC compared with Luminal A breast cancer(P>0.05).In the comparison of menstrual status,BPE and FGT in premenopausal patients were higher than those in postmenopausal patients(2 values were 20.5,18.23,P values were 0.007 and 0.004 respectively).In

关 键 词：乳腺背景实质强化 乳腺癌 分子亚型 核磁共振成像 

分 类 号：R73[医药卫生—肿瘤]