乳腺癌对比增强能谱X线表现与肿瘤浸润淋巴细胞的相关性研究  

Correlation between Contrast-Enhanced Spectral Mammography Finding and the Level of Tumor Infiltrating Lymphocytes in Breast Cancer

作　　者：荣小翠[1] 张玲玲[2] 李智岗[1] 薛晶 康一鹤 赵俊京[1] RONG Xiaocui;ZHANG Lingling;LI Zhigang(Department of Radiology,The Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei Province 050011,P.R.China)

机构地区：[1]河北医科大学第四医院放射科,石家庄050011 [2]河北医科大学第四医院病理科,石家庄050011

出　　处：《临床放射学杂志》2022年第6期1015-1018,共4页Journal of Clinical Radiology

基　　金：河北省科学技术厅重点研发计划资助项目(编号:20377783D);河北省医学科学研究重点课题项目(编号:20210838)。

摘　　要：目的探讨乳腺癌对比增强能谱X线摄影(CESM)表现与肿瘤浸润淋巴细胞(TILs)的相关性。方法回顾性分析2019年4月至2021年1月本院临床、X线摄影或超声检查发现可疑恶性肿块行CESM检查的90例乳腺癌患者资料。采用χ^(2)检验及t检验比较不同TILs浸润水平CESM影像表现及临床病理指标间的差异。结果90例浸润性癌患者中,TILs低度浸润59例(65.6%),TILs中高度浸润31例(34.4%)。TILs浸润水平与雌激素受体(ER)、孕激素受体(PR)、Ki-67表达、组织学分级及分子分型存在显著相关性(P均<0.05)。CESM肿块边缘、强化程度在不同TILs浸润水平中的差异存在统计学意义(P均<0.05),TILs中高度浸润肿块更多表现为边缘清晰、中度强化。而肿块形态、内部强化特征及强化曲线在两组间的差异无统计学意义(P均>0.05)。结论乳腺癌CESM特征与TILs浸润水平存在相关性,提示CESM对于术前乳腺癌TILs浸润水平的预测能够提供一定的影像学依据。Objective To explore the correlation between contrast-enhanced spectral mammography findings and the level of tumor infiltrating lymphocytes(TILs)in breast cancer.Methods Ninety patients who were suspected of breast masses by clinical,mammography or ultrasound examination in our hospital from April 2019 to January 2021 were retrospective analyzed.χ2 test and t test were used to compared the difference of CESM features and the clinical pathological characteristics in different TILs levels.Results In 90 patients,59(65.6%)with low and 31(34.4%)with intermediate-high TILs levels.There were statistically significant differences in ER,PR,Ki-67,histological grade and molecular subtypes between TILs low and intermediate-high levels groups(all P<0.05).There were statistically significant differences in margin and the enhancement intensity of CESM between TILs low and intermediate-high levels groups(all P<0.05),but not correlated with shape,internal enhancement and enhancement curve(all P>0.05).Tumors with intermediate-high TILs levels had more circumscribed margins and moderate enhancement on CESM.Conclusion Some features on CESM correlated with TILs levels in patients with invasive breast cancer.This findings suggest that preoperative CESM can provide certain imaging information for the prediction of TILs levels.

关 键 词：乳腺癌 对比增强能谱乳腺X线摄影 肿瘤浸润淋巴细胞 

分 类 号：R737.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]