乳腺癌患者动态增强磁共振成像扩散加权成像影像学特征及其与分子分型的相关性  

DCE-MRI and DWI imaging features and their correlation with molecular typing in breast cancer patients

作　　者：周晓军[1] 闻彩云[1] 王溯源[1] 周洁洁 吕世旭 王瓯 Zhou Xiaojun;Wen Caiyun;Wang Shuoyuan;Zhou Jiejie;Lyu Shixu;Wang Ouchen(Radiological Imaging Center,First Affiliated Hospital of Wenzhou Medical University,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第一医院放射影像中心,325000 [2]温州医科大学附属第一医院甲乳外科,325000

出　　处：《中国药物与临床》2019年第23期4040-4043,共4页Chinese Remedies & Clinics

基　　金：浙江省医药卫生计划项目(2017PY020)。

摘　　要：目的探究乳腺癌患者动态增强磁共振成像(DCE-MRI)、扩散加权成像(DWI)影像学特征及其与分子分型的相关性。方法155例乳腺癌患者(163个病灶)均于术前接受DCE-MRI和DWI检查,依据术后免疫组织化学结果分为4种不同分子分型。对比不同分子分型的表观弥散系数(ADC)、DCE-MRI定量参数[包括容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞间隙容积比(Ve)]以及微血管密度(MVD)计数、血管内皮生长因子(VEGF)水平,并分析DCE-MRI定量参数与MVD、VEGF的相关性。结果共检出Luminal A型病灶56个,Luminal B型51个,人表皮生长因子受体2(HER-2)过表达型24个,三阴型32个。Luminal A型、Luminal B型的ADC值、Ktrans值、Kep值均明显低于HER-2过表达型和三阴型,Luminal A型、Luminal B型、HER-2过表达型的Ve值均显著高于三阴型(P<0.05)。Luminal A型、Luminal B型的MVD、VEGF水平均明显低于HER-2过表达型和三阴型,HER-2过表达型的MVD、VEGF水平均明显低于三阴型(P<0.05)。Luminal A型、Luminal B型的MVD水平与Ktrans值呈正相关,与Ve值呈负相关;HER-2过表达型的MVD水平与Ktrans值呈正相关;三阴型的MVD、VEGF与Ktrans值、Kep值呈正相关,与Ve值呈负相关。结论不同分子分型乳腺癌患者的ADC值及DCE-MRI定量参数存在明显差异,且与其血管生成存在密切关系,DCE-MRI以及DWI在鉴别诊断不同分子分型乳腺癌上具有一定的临床价值。Objective To investigate the DCE-MRI and DWI imaging features and their correlation with molecular typingin breast cancer patients.Methods A total of 155 patients with breast cancer(163 lesions)underwent DCE-MRI and DWI before operation.According to the results of immunohistochemistry,four different molecular typeswere categorized.The apparent diffusion coefficient(ADC),quantitative parameters of DCE-MRI[volume transfer constant(Ktrans),rate constant(Kep),extravascular intercellular space volume ratio(Ve)],microvessel density(MVD),and level of VEGF were compared among different molecular types.The correlation between quantitative DCE-MRI parameters,MVD and VEGF was analyzed.Results Luminal A lesions were identified in 56,Luminal B lesions in 51,HER-2 over-expression lesions in 24 and triple-negative lesions in 32.The values of ADC,Ktrans and Kep with Luminal A and Luminal B lesions were significantly lower than those with HER-2 over-expression and triple-negative lesions,while the Ve values with Luminal A,Luminal B and HER-2 over-expression lesions were significantly higher than those with triple-negative lesions(P<0.05).The MVD and VEGF levels with Luminal A and Luminal B lesions were significantly lower than those with HER-2 over-expression and triple-negative lesions.The MVD and VEGF levels with HER-2 over-expression lesions were significantly lower than those with triple-negative lesions(P<0.05).Spearman correlation analysis showed that the MVD levels with Luminal A and Luminal B lesions were positively correlated with Ktrans,and were negatively correlated with Ve.The MVD with HER-2 over-expression lesions was positively correlated with the Ktrans.The MVD and VEGF level with triple-negative lesions were positively correlated with Ktrans and Kep val-ues,and negatively correlated with Ve.Conclusion The ADC values and quantitative DCE-MRI parameters in breast cancer patients vary significantly with molecular classifications,and are closely related to angiogenesis.DCE-MRI and DWI offer certain clinical value in d

关 键 词：乳腺肿瘤 磁共振成像 弥散磁共振成像 分子分型 

分 类 号：R73[医药卫生—肿瘤]