同时性双侧乳腺癌分子分型与乳腺影像表现的相关性  

Correlation Between Molecular Typing and Imaging Findings of Simultaneous Bilateral Breast Cancer

作　　者：李妍[1] 林青[1] 崔春晓[1] 苏晓慧[1] 边甜甜[1] 张琦[1] 周霞 LI Yan;LIN Qing;CUI Chunxiao;SU Xiaohui;BIAN Tiantian;ZHANG Qi;ZHOU Xia(Department of Breast Imaging,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院乳腺影像科,山东青岛266000

出　　处：《中国医学影像学杂志》2024年第5期461-467,共7页Chinese Journal of Medical Imaging

基　　金：国家重点研发计划课题(2016YFC1303004)。

摘　　要：目的分析同时性双侧乳腺癌不同分子分型与乳腺影像特征的相关性。资料与方法回顾性分析2016年1月—2022年5月青岛大学附属医院经手术病理证实的同时性双侧乳腺癌81例,其中80例接受X线检查,38例接受MRI检查。影像学特征参照第5版乳腺影像报告和数据系统。分子分型参照2013年St.Gallen国际专家共识。比较同时性双侧乳腺癌中首发癌与对侧癌的临床病理及影像表现差异以及首发癌、对侧癌不同分子分型的影像表现差异。结果首发癌与对侧癌组织学类型及分子分型差异均有统计学意义(χ^(2)=39.72、12.23,P<0.05)。X线示首发癌多为单纯肿块(51.9%,40/77),对侧癌多为单纯钙化(38.4%,28/73);首发癌多为多形性钙化(68.8%,22/32),对侧癌多为无定形钙化(45.2%,19/42)(χ^(2)=33.15、10.47,P<0.05)。MRI示首发癌与对侧癌强化方式差异有统计学意义(χ^(2)=6.79,P<0.05)。对侧癌X线示4种分子分型表现形式、肿块密度以及MRI示强化方式、早期强化程度、时间-信号强度曲线差异有统计学意义(P<0.05),对侧癌X线luminalA型多为肿块(51.3%,20/39),luminalB型(36.4%,8/22)、HER-2过表达型(50%,5/10)多为钙化,TNBC型为肿块伴钙化(χ^(2)=26.72、7.49、8.95、13.44、12.85,P<0.05)。首发癌X线示4种分子分型钙化分布差异有统计学意义(χ^(2)=20.15,P<0.05)。结论同时性双侧乳腺癌分子分型及部分影像学特征存在差异,部分影像学特征可为预测分子分型提供参考。Purpose To analyze the relationship between different molecular types and imaging manifestations of simultaneous bilateral breast cancer.Materials and Methods Eighty-one patients with simultaneous bilateral breast cancer confirmed by surgery and pathology in the Affiliated Hospital of Qingdao University from January 2016 to May 2022 were retrospectively analyzed,80 patients received mammography and 38 patients received MRI.Imaging features referred to the 5th edition of the breast imaging reporting and data system standards.Molecular typing was evaluated and classified according to the 2013 revised St.Gallen international expert consensus recommended the determination.The clinicopathological and imaging features of the index and contralateral breast cancer were compared,and the imaging features of different molecular types of the index and contralateral breast cancer were also compared.Results There were statistically significant differences in histological types and molecular typing between the index and contralateral cancers(χ^(2)=39.72,12.23,P<0.05).Mammograph showed that the index cancer was mostly a mass(51.9%,40/77),while the contralateral cancer was mostly calcification(38.4%,28/73);the index cancer was mostly polymorphic calcification(68.8%,22/32),while the contralateral cancer was mostly amorphous calcification(45.2%,19/42)(χ^(2)=33.15,10.47,P<0.05).There was a statistically significant difference in the MRI enhancement between the index cancer and the contralateral cancer(χ^(2)=6.79,P<0.05).For contralateral cancer,mammograms showed statistically significant differences in the four molecular subtypes on tumor density,as well as MRI enhancement patterns,early enhancement degree,and time-signal intensity curve(χ^(2)=26.72,7.49,8.95,13.44,12.85,P<0.05).There was a significant difference in the distribution of calcification among the four molecular subtypes on the X-ray of the first cancer(χ^(2)=20.15,P<0.05).Conclusion The molecular typing and some imaging characteristics of simultaneous bilateral bre

关 键 词：乳腺肿瘤 分子分型 乳房X线摄影术 磁共振成像 病理学 外科 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]