3种乳腺癌分子亚型与数字乳腺断层合成显像X线特征的关系:基于BI-RADS  

Relationship between molecular subtypes of breast cancer and imaging features of BI-RADS based on digital breast tomosynthesis

作　　者：梁旭[1] 徐忠孜 廖雪芮 曹英[1] 任静[1] 周鹏[1] LIANG Xu;XU Zhongzi;LIAO Xuerui;CAO Ying;REN Jing;ZHOU Peng(Department of Radiology,Sichuan Cancer Hospital,Chengdu 610041,China)

机构地区：[1]四川省肿瘤医院影像科,四川成都610041

出　　处：《分子影像学杂志》2021年第4期567-573,共7页Journal of Molecular Imaging

基　　金：国家重点研发计划项目(2017YFC0109405)。

摘　　要：目的探讨乳腺癌分子亚型与数字乳腺断层合成(DBT)X线征象的关系。方法回顾性分析153例乳腺癌患者的DBT影像及病理资料,根据雌激素受体、孕激素受体及人表皮生长因子受体2(HER2)表达水平分为激素受体(HR)阳性组(n=90)、HER2阳性组(n=20)及三阴性组(n=33)。以第5版ACR乳腺X摄影影像报告与数据系统定义的影像征象为标准,比较不同分子分型的临床病理特征及DBT征象。结果HER2+、三阴性组组织学分级、Ki67表达水平高于HR+组,差异有统计学意义(P<0.05)。3组分子亚型表现为单纯肿块、单纯钙化、肿块伴钙化、不对称致密及结构扭曲等差异无统计学意义(P>0.05)。HER2+组、三阴性组表现为圆形/卵圆形肿块发生率(50.0%、59.3%)高于HR+组(24.6%),差异有统计学意义(P=0.003);HR+组、HER2+组表现为分叶征的发生率(93.8%、95%)高于三阴性组(55.6%),差异有统计学意义(P<0.001);HR+组表现为毛刺征的发生率(72.3%)高于HER2+、三阴性组(20.0%、30.7%),差异有统计学意义(P<0.001)。HER2+组表现为细线分支状钙化及线/段样分布特征发生率高于HR+、三阴性组(P<0.001)。HER2+组、三阴性组周围腺体结构扭曲、小梁增厚发生率高于HR+组(P<0.05)。结论乳腺癌分子亚型与DBT影像征象有一定关系,认识这些征象有利于预测乳腺癌分子分型。Objective To investigate the relationship between molecular subtypes of breast cancer and the X-ray signs of digital breast tomosynthesis(DBT).Methods The DBT images and pathological data of 153 patients with breast cancer were retrospectively analyzed.According to the expression levels of estrogen receptor,progesterone receptor and human epidermal growth factor receptor 2(HER2),they were divided into hormone receptor(HR)positive group(n=90),HER2 positive group(n=30)and triple negative group(n=33).DBT signs of different molecular types were compared according to the imaging criteria defined by ACR breast reporting and data system(BI-RADS).Results The histological grade and Ki67 expression level in HER2+and triple negative groups were higher than those in HR+group(P<0.05).There were no significant differences among the three groups in simple mass,simple calcification,mass with calcification,asymmetries and architectural distortion(P>0.05).The incidence of round/oval mass in HER2+group and triple negative group was higher than that in HR+group(P=0.003).The incidence of lobulation in HR+group and HER2+group was higher than that in triple negative group(P<0.001).The incidence of spiculated sign in HR+group was higher than that in HER2+and triple negative groups(P<0.001).The incidence of fine line branched calcification and linear/segmental distribution in HER2+group was higher than that in HR+and triple negative groups(P<0.001).The incidences of architectural distortion of the surrounding glands and trabecular thickening in HER2+group and triple negative group were higher than those in HR+group(P<0.05).Conclusion The molecular subtypes of breast cancer are related to the imaging signs of DBT.Understanding these signs is helpful to predict the molecular subtypes of breast cancer.

关 键 词：数字乳腺断层合成 乳腺癌 分子亚型 

分 类 号：R737.9[医药卫生—肿瘤]