外周血淋巴细胞亚群及MRI特征在乳腺癌Luminal分型中的价值  

The Value of Peripheral Blood Lymphocyte Subsets and MRI Features in Luminal Typing of Breast Cancer

作　　者：包丰昌 王贇霞 马蕾[2] 雷平冲[1] 谭红娜 BAO Fengchang;WAND Yunxia;MA Lei(Department of Hematology,Henan Provincial People's Hospital&Peoples Hospital of Henan University,Zhengzhou,Henan Province 450003,P.R.China)

机构地区：[1]河南省人民医院血液内科&河南大学人民医院血液内科,郑州450003 [2]河南省人民医院医学影像科&河南大学人民医院医学影像科,郑州450003

出　　处：《临床放射学杂志》2023年第7期1092-1097,共6页Journal of Clinical Radiology

基　　金：河南省自然科学基金面上项目(编号:202300410081);河南省医学科技攻关计划项目(编号:LHGJ20220055)。

摘　　要：目的探讨外周血淋巴细胞亚群及MRI特征与乳腺癌Luminal分型的相关性。方法回顾性分析253例Luminal型乳腺癌外周血淋巴细胞亚群及其MRI特征,以ER阳性/HER-2阴性/Ki-67<20%/PR>20%作为Luminal A型乳腺癌分型标准将患者分成Luminal A型和B型两组。分析临床病理、外周血淋巴细胞亚群及乳腺MRI等特征在两组患者中的差异,用Logistic回归分析乳腺癌Luminal B型的独立影响因素及其预测效能。结果(1)253例Luminal型乳腺癌患者中Luminal A型61例,Luminal B型192例;病理SBR分级高、腋窝淋巴结转移及脉管侵犯的患者更易出现在Luminal B型中,且差异均有统计学意义(P值均<0.05)。(2)Luminal B型乳腺癌辅助T淋巴细胞绝对数的中位数较Luminal A型乳腺癌的低(691 vs 773),且差异有统计学意义(P=0.033)。(3)MRI上病灶越大、BI-RADS分类越高及腋窝淋巴结转移的患者易出现在Luminal B型乳腺癌患者中,且差异均有统计学意义(P值均<0.05)。(4)Logistic回归分析结果表明病理SBR 3级及MRI上病灶≥20 mm是Luminal B型乳腺癌的独立影响因素,其OR值分别为22.182和1.981;基于病理分级及MRI上病灶大小及二者联合预测Luminal B型乳腺癌的曲线下面积分别为0.678、0.623和0.740。结论乳腺癌的临床病理、外周血淋巴细胞亚群及MRI特征与Luminal分型有一定的相关性,且病理分级及MRI上病灶大小是Luminal B型乳腺癌的独立影响因素。Objective To investigate the correlation of peripheral blood lymphocyte subsets and MRI features with Luminal types in breast cancer.Methods The data of peripheral blood lymphocyte subsets and MRI characteristics of 253 Luminal breast cancer patients were retrospectively analyzed.According the definition of Luminal A tumors with HR positive/HER-2 negative/Ki-6720%/PR 20%,the patients were divided into Luminal A and Luminal B breast cancer groups.The differences in clinicopathology,peripheral blood lymphocyte subsets and breast MRI between the two groups were analyzed,and the independent factors and predictive efficiency of Luminal B breast cancer were analyzed by Logistic regression.Results(1)Among 253 Luminal breast cancer patients,61 patients were Luminal A type and 192 patients showed Luminal B type.Patients with high pathological grade,axillary lymph node metastasis and vascular invasion were more likely to be the type of Luminal B breast cancer(allPvalues 0.05).(2)The median absolute number of helper T lymphocytes in Luminal B breast cancer was lower than that of in Luminal A breast cancer(691 vs 773),and the difference was statistically significant(P=0.033).(3)On MRI,patients with larger lesion size,higher BI-RADS classifications and suspected axillary lymph node metastasis were more likely to be Luminal B breast cancer,and the differences were statistically significant(allP<0.05).(4)Logisticregression results showed that pathological SBR 3 grade and lesion size≥20mm on MRI were the independent influence factors of Luminal B breast cancer,with the OR values of 22.182 and 1.981,respectively;and the AUC values of pathological grade,lesion size on MRI and their combination were 0.678,0.623 and0.740,respectively.Conclusion The clinicopathology,peripheral blood lymphocyte subsets and breast MRI features have some correlations with Luminal types in breast cancer,and pathological grade and lesion size on MRI were the independent influence factors for Luminal B breast cancer.

关 键 词：乳腺肿瘤 Luminal型乳腺癌 淋巴细胞亚群 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤]