术前DCE-MRI联合miR-34a在乳腺癌术后复发转移危险度分层中作用研究  

The Role of Preoperative DCE-MRI Combined with miR-34a in Risk Stratification of Postoperative Recurrence and Metastasis of Breast Cancer

作　　者：肖虎 戴帆琦 程涛 惠鹏 Xiao Hu;DAI Fan-Qi;CHENG Tao;Hui Peng(Ankang Central Hospital,Ankang 725000,Shaanxi Province,China)

机构地区：[1]安康市中心医院,陕西安康725000

出　　处：《中国CT和MRI杂志》2023年第12期85-88,共4页Chinese Journal of CT and MRI

基　　金：陕西省医学科学研究课题计划(2019JM2114)。

摘　　要：目的研究术前动态增强磁共振成像(DCEMRI)联合微小RNA-34a(miR-34a)在乳腺癌术后复发转移危险度分层中作用。方法选取2018年4月~2021年5月276例乳腺癌患者,术前均行DCE-MRI检查,采用实时荧光定量PCR法检测术前血清miR-34a表达,根据术后1年是否发生复发转移分为高危组(发生复发转移)、低危组(未发生复发转移),比较两组术前DCE-MRI特征和血流动力学参数[血浆容积分数(Vp)、达峰时间(TTP)、速率常数(Kep)、对比剂最大浓度值(Max Slope)、时间信号强度曲线下面积(AUC)、时间信号强度曲线最大斜率值(Max Cone)]、血清miR-34a,采用多因素Logistic回归分析术后复发转移的相关影响因素,采用受试者工作特征曲线(ROC)分析术前DCE-MRI、miR-34a及联合评估复发转移危险度的价值。结果高危组病灶内部强化特征、病灶边缘、背景实质强化、全乳血管增加程度、时间信号强度曲线类型、病灶形态与低危组比较,差异无统计学意义(P>0.05);高危组Max Slope、AUC、Max Cone低于低危组,差异有统计学意义(P<0.05);高危组血清miR-34a低于低危组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,Max Slope、AUC、Max Cone、miR-34a与术后复发转移独立相关(P<0.05);绘制ROC曲线显示,Max Slope、AUC、Max Cone、miR-34a预测术后复发转移的ROC曲线下面积为0.745、0.792、0.771、0.762,四者联合的ROC曲线下面积为0.930。结论Max Slope、AUC、Max Cone、miR-34a均与乳腺癌术后复发转移有关,术前联合进行DCE-MRI和miR-34a检测,可早期无创、准确地预测患者术后复发转移的风险,从而指导临床后续的管理,提高患者生存期。Objective To investigate the role of preoperative dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with microRNA-34a(miR-34a)in risk stratification of postoperative recurrence and metastasis of breast cancer.Methods A total of 276 breast cancer patients from April 2018 to May 2021 were selected.All patients underwent DCE-MRI examination before operation,and real-time quantitative PCR was used to detect the expression of miR-34a in serum before operation.According to whether recurrence and metastasis occurred 1 year after operation The patients were divided into high-risk group(with recurrence and metastasis)and low-risk group(without recurrence and metastasis).The preoperative DCE-MRI characteristics and hemodynamic parameters plasma volume fraction(Vp),time to peak(TT P),Rate constant(Kep),maximum concentration of contrast agent(Max Slope),area under the time signal intensity curve(AUC),time signal intensity curve maximum slope value(Max Cone),serum miR-34a,using multivariate logistic regression analysis The related influencing factors of postoperative recurrence and metastasis were analyzed by receiver operating characteristic curve(ROC)to analyze the value of preoperative DCE-MRI,miR-34a and combined risk assessment of recurrence and metastasis.Results Compared with the low-risk group,there was no significant difference in the internal enhancement characteristics,lesion margin,background parenchymal enhancement,degree of whole breast blood vessel increase,time signal intensity curve type,and lesion morphology between the high-risk group and the low-risk group(P>0.05),AUC and Max Cone were lower than those in the low-risk group,and the difference was statistically significant(P<0.05);the serum miR-34a in the high-risk group was lower than that in the low-risk group,and the difference was statistically significant(P<0.05).It showed that Max Slope,AUC,Max Cone,and miR-34a were independently correlated with postoperative recurrence and metastasis(P<0.05);Drawing the ROC curve showed that the a

关 键 词：DCE-MRI MIR-34A 乳腺癌 术后复发转移 危险度 预测价值 

分 类 号：R737.9[医药卫生—肿瘤]