基于体素内不相干运动模型的扩散加权成像定量参数对老年乳腺癌患者的诊断价值及其与肿瘤恶性程度的相关性  

Diagnostic value of IVIM-DWI quantitative parameters for elderly breast cancer and their correlation with tumor malignancy

作　　者：颜景春 赵静 崔志超[3] 杜建文[4] YAN Jing-Chun;ZHAO Jing;CUI Zhi-Chao;DU Jian-Wen(Department of Radiology,Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,Hebei Province,China;Faculty of Clinical Medicine,Tangshan Vocational and Technical College,Tangshan 063004,Hebei Province,China;Department of Breast,Tangshan People′s Hospital,Tangshan 063000,Hebei Province,China;Department of Ultrasonography,Chengde Central Hospital,Chengde 067024,Hebei Province,China)

机构地区：[1]唐山市中医医院放射科,河北唐山063000 [2]唐山市职业技术学院临床系,河北唐山063004 [3]唐山市人民医院乳腺科,河北唐山063000 [4]承德市中心医院超声科,河北承德067024

出　　处：《中华老年多器官疾病杂志》2022年第6期428-433,共6页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：河北省医学科学研究课题(20191301)。

摘　　要：目的探讨基于体素内不相干运动模型的扩散加权成像(IVIM-DWI)定量参数对老年乳腺癌的诊断价值及其与肿瘤恶性程度的相关性。方法选择河北省4所医院2015年4月至2020年2月收治的102例老年乳腺癌患者为乳腺癌组,选择同期95例乳腺良性病变患者为对照组。分析IVIM-DWI定量参数对老年乳腺癌患者的诊断效能及其与乳腺癌恶性程度的相关性。采用SPSS 21.0统计软件进行数据分析。计量资料比较采用t检验。采用Pearson相关分析IVIM-DWI定量参数与组织标本中增殖基因(Notch1、CXCL1)、侵袭基因(FOXF1、NUAK1)及自噬基因(ATG4D、ATG2B)的相关性。结果乳腺癌组表现扩散系数(ADC)值、真实扩散系数(D)值、灌注相关扩散系数(D^(∗))值及自噬相关基因4D(ATG4D)、自噬相关基因2B(ATG2B)表达量均低于对照组;灌注分数(f)值及Notch1、CXCL1、FOXF1、NUAK1表达量高于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析显示,老年乳腺癌患者ADC值、D值、D^(∗)值、f值与组织标本中Notch1、CXCL1、FOXF1、NUAK1基因表达量呈正相关(P<0.05),与组织标本中ATG4D、ATG2B表达量呈负相关(P<0.05)。ROC曲线下D值的曲线下面积(AUC)最大,AUC为0.952,灵敏度为96.05%,特异度为85.38%。浸润性导管癌、组织学分级G_(3)、临床分期Ⅲ~Ⅳ期、有淋巴结转移的乳腺癌患者D值明显低于病理其他类型、组织学分级G_(1+2)、临床分期Ⅰ~Ⅱ期、无淋巴结转移的患者,差异有统计学意义(P<0.05)。结论老年乳腺癌患者IVIM-DWI定量参数值异于乳腺良性病变患者,且其参数变化与肿瘤恶性程度直接相关,可作为临床早期筛查与恶性程度评估的有效手段。Objective To explore the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)quantitative parameters in the clinical diagnosis of elderly breast cancer and their relationship with tumor malignancy.Methods A total of 102 elderly patients with breast cancer admitted to four hospitals of Hebei Province from April 2015 to February 2020 were recruited and assigned into the breast cancer group,and another 95 patients with benign breast lesions during the same period served as the control group.The diagnostic efficiency of IVIM-DWI quantitative parameters and their correlation with tumor malignancy were analyzed.SPSS statistics 21.0 was used for data analysis.Measurement data was tested by student′s t test.Pearson correlation analysis was adopted to analyze the correlation of IVIM-DWI quantitative parameters with the expression of proliferation genes(Notch1,CXCL1),invasion genes(FOXF1,NUAK1)and autophagy genes(ATG4D,ATG2B)in the breast cancer tissues.Results The apparent diffusion coefficient(ADC)value,diffusion coefficient(D)value,perfusion related diffusion coefficient(D^(∗))value and expression levels of ATG4D and ATG2B were significantly lower,while perfusion fraction(f)value and expression levels of Notch1,CXCL1,FOXF1 and NUAK1 were obviously higher in the breast cancer group than the control group(P<0.05).Pearson correlation analysis showed that ADC value,D value,D^(∗)value,f value were positively correlated with the expression levels of Notch1,CXCL1,FOXF1 and NUAK1 and negatively with those of ATG4D and ATG2B in the tissue specimens of the elderly breast cancer patients(P<0.05).The D value under the receiver operating characteristic(ROC)curve had the largest AUC of 0.952,a sensitivity of 96.05%,and a specificity of 85.38%.The D value was significantly lower in the breast cancer patients with invasive ductal carcinoma,histological grade G_(3),clinical stageⅢ-Ⅳ,and lymph node metastasis than those with other types of pathology,histological grade G_(1+2),clinical stageⅠ-Ⅱ,and no l

关 键 词：老年人 乳腺癌 乳腺良性病变 IVIM-DWI定量参数 增殖基因 侵袭基因 

分 类 号：R737.9[医药卫生—肿瘤]