乳腺癌对比增强能谱X线摄影的强化特点与分子亚型对照分析  

Enhancement features and comparative analysis of molecular subtypes of contrast-enhanced spectral X-ray in breast cancer

作　　者：李鸿恩 李悦龙 谢汉民 邱琳 黄芷晴 曾益辉 LI Hong-en;LI Yue-long;XIE Han-min(Department of Radiology Guangdong Province Hospital for Women and Children Healthcare,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院放射科,广州511400

出　　处：《放射学实践》2023年第7期898-904,共7页Radiologic Practice

摘　　要：目的:研究乳腺癌对比增强能谱X线摄影(CESM)的影像学特征、强化特点与分子亚型的相关性。方法:回顾性分析本院经病理及免疫组化确诊的56例乳腺癌患者的病例资料。所有患者于病理检查前行CESM检查,观察病变影像学特征,包括强化程度、强化均匀性及强化模式。随后,病理行免疫组化染色,并根据免疫组化标记物表达情况将乳腺癌分为:Luminal A型、Luminal B型、Her-2过表达型、三阴性型四组分子亚型。研究不同分子亚型乳腺癌与CESM强化特点及病理表现之间的相关性。结果:56例乳腺癌患者中,Luminal B型25例(44.64%),Her-2过表达型13例(23.21%),Luminal A型11例(19.64%),三阴性型7例(12.50%)。在不同分子亚型乳腺癌临床病理特征中,不同年龄区间、病理类型分布及有无淋巴结转移在四组分子亚型乳腺癌患者之间差异无统计学意义(P均>0.05)。然而,影像学特征的强化程度在不同分子亚型之间存在差异有统计学意义(χ^(2)=20.597,P<0.05)。而强化均匀性和强化模式在不同分子亚型间差异无统计学意义(χ^(2)=6.507、9.418,P均>0.05)。在强化均匀性方面,Luminal A型与三阴性型之间具有差异有统计学意义(q<0.0083)。其余亚型之间差异无统计学意义。结论:Luminal A型乳腺癌多表现为显著强化、流出型,Luminal B型多表现为显著强化、不均匀强化,Her-2过表达型多表现为中度强化、不均匀强化及流出型,三阴性型多表现为淋巴结转移、不均匀强化及中度强化。乳腺癌CESM病灶强化特点与不同分子亚型存在一定关系,对于临床术前预测乳腺癌分子亚型具有一定指导作用。Objective:To investigate the imaging features and enhancement features of contrast-enhanced spectral mammography(CESM)in relation to molecular subtypes of breast cancer.Methods:A retrospective analysis was conducted on clinical data of 56 breast cancer patients diagnosed by pathology and immunohistochemistry in our hospital.All patients underwent CESM examination before the pathological examination to observe the imaging features of the lesions,including the degree of enhancement,uniformity of enhancement,and enhancement patterns.Subsequently,immunohistochemistry staining was performed,and based on the expression of immunohistochemical markers,breast cancer was classified into four molecular subtypes:Luminal A,Luminal B,Her-2 overexpression,and triple-negative.The correlation between different molecular subtypes of breast cancer and CESM enhancement characteristics and pathological manifestations was studied.Results:Among the 56 cases of breast cancer patients,there were 25 cases(44.64%)of Luminal B subtype,13 cases(23.21%)of Her-2 overexpression subtype,11 cases(19.64%)of Luminal A subtype,and 7 cases(12.50%)of triple-negative subtype.There were no significant statistical differences(all P>0.05)among the four molecular subtypes of breast cancer regarding age distribution,pathological types,and presence of lymph node metastasis.However,there was a significant statistical difference(χ^(2)=20.597,P<0.05)in the degree of enhancement among different molecular subtypes.There were no statistical differences(χ^(2)=6.507,9.418,both P>0.05)in terms of enhancement uniformity and enhancement pattern among different molecular subtypes.Regarding enhancement uniformity,there was a significant statistical difference(q<0.0083)between Luminal A subtype and triple-negative subtype.No significant statistical differences were observed among the remaining subtypes.Conclusion:Luminal A subtype of breast cancer tends to exhibit significant enhancement and washout pattern,while Luminal B subtype often presents with significant enhance

关 键 词：对比增强能谱乳腺X线摄影 强化特点 乳腺肿瘤 分子亚型 

分 类 号：R814.41[医药卫生—影像医学与核医学] R737.9[医药卫生—放射医学]