乳腺粘液癌的MRI影像学特征及与肿瘤标准物相关性研究  

MRI Fea tures of Breast Mu cinous Carcinoma and Its Correlation with Tumor Biomarkers

作　　者：王柯懿 张文渊 肖学红[1] 杨昂[1] 黄晓星[1] 王志龙[1] WANG Ke-yi;ZHANG Wen-yuan;XIAO Xue-hong;YANG Ang;HUANG Xiao-xing;WANG Zhi-long(Magnetic Resonance Room,Zhongshan People's Hospital,Guangdong Province,Zhongshan 528403,Guangdong Province,China;Department of Pharmacy,Zhongshan People's Hospital,Zhongshan 528403,Guangdong Province,China)

机构地区：[1]广东省中山市人民医院磁共振室,广东中山528403 [2]广东省中山市人民医院药学部,广东中山528403

出　　处：《中国CT和MRI杂志》2022年第11期96-97,117,共3页Chinese Journal of CT and MRI

基　　金：中山市卫生健康局科研项目(2020A020514)。

摘　　要：目的回顾性分析乳腺粘液癌的磁共振特征,并分析MRI测量最大径与肿瘤标志物的相关性。方法收集2010年7月至2020年7月某三甲医院病理证实乳腺粘液癌18例(单纯型16例、混合型2例),分析患者MRI为主的影像学数据,测量并记录其影像学特征;同时收集患者治疗前癌胚抗原(CEA)、糖链抗原15-3(CA153)水平。结果乳腺粘液癌患者治疗前CEA水平为3.2±4.1ng/mL,CA153为12.1±24.4U/mL;CA153与肿瘤最大径显著正相关(r=0.7,P﹤0.01),而CEA不存在相关关系。单纯型粘液癌以边缘较光滑的分叶形肿块为主,在STIR及ADC多数表现为高信号,并呈延时强化模式,50%有包膜信号;实性成分较多的单纯型粘液癌与混合型粘液癌在STIR表现相似,两者的实性成分ADC均为低信号。边缘不光整、纤维包膜不完整、且实质成分较多的单纯型粘液癌腋窝淋巴结转移者较多。结论乳腺粘液癌在磁共振部分可见纤维包膜等特殊影像学特征可以协助诊断,CA153同肿瘤最大径存在一定相关性。Objective To retrospectively analyze the MRI features of breast mucinous carcinoma,and to analyze the correlation between the MRI-measured maximum diameterand tumor markers.Methods From July 2010 to July 2020,18 cases of breast mucinous carcinoma(16 cases of pure type and 2 cases of mixed type)confirmed by pathology were collected in a tertiary hospital.The MRI imaging data were measured and recorded.Meanwhile,the levels of CEAand CA153before treatment were collected.Results The levels of CEA and CA153 were 3.2±4.1 ng/mL and 12.1±24.4 U/mL,respectively.CA153was positively correlated with the tumorous maximum diameter(r=0.7,P﹤0.01),but there was no correlation between CEA and the tumorous maximum diameter.Pure mucinous carcinoma was mainly lobulated mass with smooth margin.On STIR and ADC,most of pure mucinous carcinoma showed high signal intensity and delayed enhancement pattern,and 50%of them had capsular signal.The pure mucinous carcinoma with more solid components and mixed mucinous carcinoma showed similar findings on STIR,and the ADC of both solid components was low signal.Axillary lymph node metastasis was more common in pure mucinous carcinoma with irregular margin,incomplete fibrous capsule and more solid components.Conclusion The special MRI features of breast mucinous carcinoma such as fibrous capsule can be helpful in the diagnosis.There is a correlation between CA153 and the tumorous maximum diameter.

关 键 词：1.5T磁共振 单纯型粘液癌 混合型粘液癌 磁共振良恶性特征 CA153 

分 类 号：R445.2[医药卫生—影像医学与核医学]