磁共振弥散峰度成像在乳腺癌中医辨证分型及其不同生物预后因子中的应用  

The application of diffusion kurtosis imaging in traditional Chinese medicine syndrome differentiation and different biological prognostic factors of breast cancer

作　　者：刘玉凤[1] 李嘉颖 王世威[1] 高秀飞[1] 渠静静 王春丹[1] 肖凤春 Liu Yufeng

机构地区：[1]浙江中医药大学附属第一医院,浙江省中医院,310018

出　　处：《浙江临床医学》2021年第8期1117-1119,1122,共4页Zhejiang Clinical Medical Journal

基　　金：浙江省卫生厅平台骨干项目(2016RCA025);浙江省中医药科学研究基金资助项目(2018ZB048)。

摘　　要：目的探讨磁共振弥散峰度成像在乳腺癌中医辨证分型及其不同生物预后因子中的应用价值。方法前瞻性选入2016年1月至2020年11月本院乳腺癌患者67例,经中医辨证分型及弥散峰度成像(DKI)扫描检查,对不同中医证型(肝郁痰凝证、冲任失调证)及生物预后因子(ER、FR、Ki-67)间的DKI参数(MD、MK、Da、Dr、Ka、Kr、FA、FAK)进行统计学差异分析。结果乳腺癌中医辨证分型,肝郁痰凝证43例,冲任失调证26例。肝郁痰凝证组,ER(+)和ER(-)组的平均弥散率(MD)、平均峰度(MK)、径向弥散率(Dr)、轴向峰度(Ka)、径向峰度(Kr)比较,差异有统计学意义(P<0.05)。乳腺癌ER(-)组,肝郁痰凝证组和冲任失调证组之间的FA参数有统计学差异(F=0.044)。冲任失调证组,PR(+)组和PR(-)组的各向异性分数(FA)、峰度各向异性分数(FAK)比较,差异有统计学意义(P<0.05)。PR(-)组,肝郁痰凝证组和冲任失调证组的FA(P=0.031)、FAK(P=0.045)有统计学差异。结论DKI参数不仅有助于乳腺癌不同中医证型的评估,而且也有助于乳腺癌生物预后因子ER基因和PR基因表达情况的评估。Objective To study the appEcation value of diffusion kurtosis imaging(DKI)in traditional Chinese medicine(TCM)syndrome differentiation ofbreast cancer and in different biological prognostic factors.Methods 69 patients of breast cancer who underwent DKI and different TCM syndrome differentiation were enrolled between January 2016 and November 2020.TCM syndrome types(liver-qi depression and phlegm,Chong and ren disorders card),difierent biological prognostic factors,and DKI parameters were analyzed.Results TCM syndrome difierentiation of breast cancer were divided in two types,including a total of 43 cases of liver-qi depression and phlegm,26 cases Chong and ren disorders card.In the liver-qi depression and phlegm,there was statistical difference in MD,MK,Dr,Ka,and Kr parameters(P<0.05)between ER(+)and ER(-)groups.In the ER(-)group,FA parameter(P<0.05)had statistical difference between two TCM syndrome differentiation.In the Chong and ren disorders card group,there was statistical difference in FA and FAK parameters(P<0.05)between PR(+)and PR(-)groups.In the PR(-)group,FA and FAK parameters(P<0.05)had statistical difierence between two TCM syndrome differentiation.Conclusion DKI parameters can contribute to not only distinguishing different TCM syndrome types of breast cancer,but ako evaluating the expression of ER and PR of biological prognostic factors.

关 键 词：乳腺癌 中医证型 弥散峰度成像 生物预后因子 

分 类 号：R73[医药卫生—肿瘤]