乳腺癌不同分子亚型的动态对比增强MRI影像学特征分析及ADC特点研究  

Analysis of dynamic contrast-enhanced MRI image and apparent diffusion coefficient features of different molecular subtypes of breast cancer

作　　者：贺春燕 高岩峰[1] He Chunyan;Gao Yanfeng(Department of Radiology,the Affiliated People's Hospital of Inner Mongolia Medical University,Hohhot 010020,China)

机构地区：[1]内蒙古医科大学附属人民医院放射科,呼和浩特010020

出　　处：《国际放射医学核医学杂志》2021年第7期427-433,共7页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨乳腺癌不同分子亚型的动态对比增强磁共振成像(DCE-MRI)影像学征象及表观扩散系数(ADC)特点。方法回顾性分析2018年1月至2020年1月于内蒙古医科大学附属人民医院就诊并经免疫组织化学染色法检查证实的138例乳腺癌女性患者的临床资料,患者年龄27~71(56.1±5.6)岁。所有患者均于术前行乳腺常规MRI扫描,根据乳腺影像报告和数据系统分析乳腺癌不同分子亚型的DCE-MRI特征;测量ADC并分析其特点。术后采用免疫组织化学染色法将乳腺癌分为不同分子亚型。采用卡方检验或Fisher确切概率法分析DCE-MRI特征与乳腺癌分子亚型的关系。采用单因素方差分析比较各分子亚型的ADC。结果138例乳腺癌患者的免疫组织化学染色法检测结果显示,Luminal A型14例、Luminal B型62例、HER-2过表达型33例、基底细胞样型29例。4种乳腺癌分子亚型中,基底细胞样型较其他3种类型体积大(χ^(2)=0.70、15.21、6.87,均P<0.01);Luminal A型多边缘光滑,其他3种类型边缘多不规则(χ^(2)=26.41、7.23、7.88,均P<0.01);基底细胞样型乳腺癌多呈边缘强化,而Luminal A型乳腺癌多呈均匀强化,且其动态增强扫描时间-信号曲线(TIC)类型以Ⅱ型居多,其他3种类型的TIC类型以Ⅲ型为主(χ^(2)=12.325,P<0.01)。所有患者病灶的ADC为(0.497×10^(-3)~1.367×10^(-3))mm^(2)/s[(0.865±0.021)×10^(-3) mm^(2)/s]。HER-2过表达型乳腺癌的ADC最高[(1.023±0.027)×10^(-3) mm^(2)/s],基底细胞样型和Luminal A型乳腺癌次之[(0.957±0.025)×10^(-3) mm^(2)/s和(0.902±0.033)×10^(-3) mm^(2)/s],Luminal B型乳腺癌最低[(0.852±0.013)×10^(-3) mm^(2)/s]。HER-2过表达型乳腺癌的ADC与基底细胞样型及Luminal B型之间的差异均有统计学意义(F=11.80、12.40,均P<0.01),Luminal B型与Luminal A型之间的差异有统计学意义(F=25.50,P<0.01)。结论乳腺癌各分子亚型的DCE-MRI影像学征象及ADC具有一定的特征性,可为乳腺癌患者术前预�Objective To explore the characteristics of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and apparent diffusion coefficient(ADC)of different molecular subtypes of breast cancer.Methods The clinical data of one hundred thirty-eight women aged 27-71(56.1±5.6)years and diagnosed with breast cancer,which was confirmed via immunohistochemical examination,at the Affiliated People's Hospital of Inner Mongolia Medical University were retrospectively analyzed from January 2018 to January 2020.All patients underwent routine breast MRI scanning before operation.DCE-MRI features of different molecular subtypes of breast cancer were analyzed using the breast imaging report and data system.ADC was measured and its characteristics were analyzed.The breast cancer was divided into non molecular subtypes via immunohistochemical staining after operation.Chi-square test and Fisher test was used to analyze the relationship between DCE-MRI features and molecular subtypes of breast cancer.The ADC of each molecular subtype was compared using one-way ANOVA.Results The immunohistochemical results showed that 138 cases of breast cancer are composed of 14 cases of Luminal A,62 cases of Luminal B,33 cases of HER-2 overexpression,and 29 cases of Basal-like subtypes.Among the four molecular subtypes of breast cancer,Basal-like subtype is the largest type of tumor(χ^(2)=0.70,15.21,6.87;all P<0.01).Edges of Luminal A type are smooth,and those of the other types are irregular(χ^(2)=26.41,7.23,7.88;all P<0.01).Basal-like subtype breast cancer showed ring enhancement,while Luminal A type breast cancer presented homogeneous enhancement.The dynamic enhanced scan time signal intensity curve(TIC)was mostly typeⅡ,while the three other types of TIC were mainly typeⅢ(χ^(2)=12.325,P<0.01).The ADC range of lesions in all patients was(0.497×10^(-3)-1.367×10^(-3))mm^(2)/s[(0.865±0.021)×10^(-3) mm^(2)/s].HER-2 overexpressing breast cancer presented the highest ADC at(1.023±0.027)×10^(-3) mm^(2)/s,followed by Basal-like subtype bre

关 键 词：乳腺肿瘤 磁共振成像 分子分型 生物学因子 

分 类 号：R737.9[医药卫生—肿瘤]