不同管腔上皮类型乳腺癌的X线和MRI特征及其对乳腺癌前哨淋巴结转移的预测  

X-Ray and MRI Characteristics of Different Luminal Breast Cancers and Their Predictive Value for Sentinel Lymph Node Metastasis in Breast Cancer

作　　者：姜剑榕 陈宋全 李毓安 曾凤仙 JIANG Jianrong;CHEN Songquan;LI Yuan(Department of Radiology and Imaging,Mindong Hospital Affiliated to Fujian Medical University,Fuan,Fujian Province 355000,P.R.China)

机构地区：[1]福建医科大学附属闽东医院放射影像科,福安355000

出　　处：《临床放射学杂志》2024年第5期718-723,共6页Journal of Clinical Radiology

摘　　要：目的 分析不同管腔上皮类型乳腺癌的MRI和钼靶X线特征及其对乳腺癌前哨淋巴结(SLN)转移的预测。方法 回顾性分析2020年1月至2022年4月收治的88例管腔型乳腺癌患者临床资料,依据分子分型分为两组,即Luminal A型组和Luminal B型组;对患者行MRI检查及钼靶X线检查;通过后处理工作站测定表观扩散系数(ADC)、灌注系数(f值)及最大上升斜率(MSI值)、真实扩散系数(D值)影像学参数。比较Luminal A型组和Luminal B型组各参数之间的差异,并绘制受试者工作特征曲线(ROC)评价各参数在乳腺肿瘤鉴别诊断中的效能。结果 Luminal A型和Luminal B型患者ADC、f及MSI值无明显差异(P>0.05),Luminal A型患者D值明显高于Luminal B型,肿瘤早期强化率(SER)值明显高于Luminal B型,且差异存在统计学意义(P<0.05);采用MRI-D、MRI-SER、MRI-D/SER联合及钼靶X线评估Luminal A型的曲线下面积(AUC)分别为0.869、0.882、0.915及0.911;采用MRI-D、MRI-SER、MRI-D/SER联合及钼靶X线预测SLN转移的AUC分别为0.885、0.953、0.979及0.966。结论 MRI-D、MRI-SER、MRI-D/SER联合及钼靶X线在鉴别乳腺癌亚型和预测SLN转移中表现出较高的准确率。Objective To analyze the X-ray and MRI characteristics of different luminal breast cancers, and to evaluate their predictive value for sentinel lymph node(SLN) metastasis in breast cancer. Methods Clinical data of 88 patients with luminal breast cancer admitted between January 2020 and April 2022 were retrospectively analyzed. Patients were classified into Luminal A and Luminal B according to molecular typing. MRI and molybdenum target X-ray images were performed. Diffusion parameters including apparent diffusion coefficient(ADC),perfusion fraction(f),maximum slope of increase(MSI),and true diffusion coefficient(D) were measured using post-processing techniques. Then receiver operating characteristic curve was plotted to evaluate the effectiveness of each parameter in the differential diagnosis of breast cancers. Results No statistical difference was reported in ADC,f, and MSI values between Luminal A type and Luminal B type(P>0.05),whereas Luminal A type patients yielded a higher D values and higher SER values than Luminal B type patients, with statistical difference(P<0.05).The areas under the curve(AUCs) of MRI-D,MRI-SER,MRI-D/SER,and molybdenum target X-ray in the diagnosis of Luminal A type were 0.869,0.882,0.915,and 0.911,respectively. The AUCs of MRI-D,MRI-SER,MRI-D/SER,and molybdenum target X-ray in the diagnosis of SLN metastasis were 0.885,0.953,0.979,and 0.966. Conclusion MRI-D,MRI-SER,MRI-D/SER and molybdenum target X-ray have high accuracy in differentiating breast cancer subtypes and predicting SLN metastasis.

关 键 词：不同管腔上皮类型 乳腺癌 磁共振成像 钼靶X线特征 乳腺癌前哨淋巴结转移 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R730.44