乳腺导管原位癌MRI表现与p53表达及临床病理的关系  

The Relationship between MRI Findings,p53 Expression,and Clinical Pathology of Ductal Carcinoma in Situ of the Breast

作　　者：王小英 顾海玉 金红玉 WANG Xiaoying;GU Haiyu;JIN Hongyu(CT and MR Room,Nanchang People's Hospital,Nanchang 330008,China;不详)

机构地区：[1]南昌市人民医院CT室,江西南昌330008 [2]江西省妇幼保健院影像科,江西南昌330006

出　　处：《中国医学创新》2024年第4期140-145,共6页Medical Innovation of China

摘　　要：目的:探讨分析乳腺导管原位癌(DCIS)磁共振成像(MRI)表现与p53蛋白(p53)表达及临床病理的关系。方法:回顾性研究60例2018年1月—2021年12月在南昌市人民医院经手术病理证实的DCIS患者的乳腺MRI平扫+增强的资料,观察记录患者病理分级和MRI表现[动态增强曲线、早期强化率、表观弥散系数(ADC)、病灶形态学],采用免疫组化法检测癌组织p53表达情况,分析MRI表现与p53表达及临床病理的关系。结果:DCIS患者MRI表现主要为非肿块强化37例(61.67%,37/60),以节段性强化(19例,51.35%)和簇环强化(17例,45.95%)为主。动态增强曲线主要以Ⅰ型为主(25例,41.67%),早期强化率以早期快速强化为主(22例,36.67%)。ADC值<1.0×10^(-3)mm^(2)/s较多,占65.00%(39/60)。p53阳性、高核级别中TIC类型为Ⅲ型和早期快速强化占比均显著高于p53阴性、非高核级别,差异均有统计学意义(P<0.05);p53(阳性、阴性)和病理分级(高核级别、非高核级别)在形态学、非肿块强化分布形式和内部强化及ADC比较,差异均无统计学意义(P>0.05)。p53表达与病理分级有关。高核级别的DCIS患者p53阳性表达发生率更高,差异有统计学意义(P<0.05)。结论:DCIS患者MRI表现具有特异性,主要表现为节段性分布和簇环强化的非肿块强化,以早期快速强化和I型TIC曲线多为常见。MRI表现与p53表达和临床病理分级有关,通过分析MRI表现可为DCIS患者的治疗和预后提供参考。Objective:To explore and analyze the relationship between magnetic resonance imaging(MRI)findings,p53 protein(p53)expression and clinicopathology in ductal carcinoma in situ of breast(DCIS).Method:A retrospective study was conducted on MRI plain scan+enhancement data of 60 patients with surgically and pathologically confirmed DCIS in Nanchang People's Hospital between January 2018 and December 2021,the pathological grading and MRI findings[dynamic enhancement curve,early enhancement rate,apparent diffusion coefficient(ADC),focal morphology]of patients were observed and recorded,the expression of p53 in carcinoma tissues was detected by immunohistochemistry,the relationship between MRI findings,p53 expression and clinicopathology was analyzed.Result:The main MRI findings in DCIS patients were non-mass enhancement[37 cases(61.67%,37/60)],which was mainly on segmental enhancement(19 cases,51.35%)and cluster-ring enhancement(17 cases,45.95%).The dynamic enhancement curves were mainly on typeⅠ(25 cases,41.67%),and early enhancement rate was mainly on fast enhancement(22 cases,36.67%).The proportion of cases with ADC value<1.0×10^(-3)mm^(2)/s was high[65.00%(39/60)].The proportions of typeⅢTIC and early fast enhancement in p53 positive and high nuclear grading were significantly higher than those in p53 negative and non-high nuclear grading,the differences were statistically significant(P<0.05);but there were not significant differences in morphology,distribution of non-mass enhancement,internal enhancement or ADC among patients with different p53 expression(positive,negative)and pathological grading(high nuclear grade,non-high nuclear grade)(P>0.05).The expression of p53 was related to pathological grading.The incidence of p53 positive was higher in patients with high nuclear grade of DCIS,the difference was statistically significantly(P<0.05).Conclusion:MRI findings are specific in DCIS patients,which are mainly characterized by non-mass enhancement with segmental distribution and cluster-ring enhancement,and ea

关 键 词：乳腺导管原位癌 磁共振成像 P53蛋白 病理分级 

分 类 号：R737.9[医药卫生—肿瘤]