磁共振弛豫时间定量成像预测乳腺浸润性导管癌分子亚型的价值  

The value of magnetic resonance relaxation time quantitative imaging in predicting molecular subtypes of invasive ductal carcinoma

作　　者：朱刚明[1] 董永德 朱瑞婷 谭源满 陶娟[1] 刘晓[1] 陈德成 杨概 ZHU Gangming;DONG Yongde;ZHU Ruiting;TAN Yuanman;TAO Juan;LIU Xiao;CHEN Decheng;YANG Gai(Department of Radiology,Dongguan Tungwah Hospital/Dongguan Medical Imaging Functional Imaging and Artificial Intelligence Application Key Laboratory,Dongguan 523808,China)

机构地区：[1]东莞东华医院放射科,东莞市医学影像功能成像与人工智能应用重点实验室,523808

出　　处：《天津医药》2024年第7期770-775,共6页Tianjin Medical Journal

基　　金：东莞市社会发展科技项目重点项目(20211800904732)。

摘　　要：目的探讨磁共振弛豫时间定量成像对乳腺浸润性导管癌(IDC)分子亚型的预测价值。方法对79例IDC患者行MRI常规扫描及弛豫时间定量成像,根据病灶免疫组化结果分为不同的免疫组化指标组、分子亚型组,比较各组病灶MRI征象、T_(1)值、T_(2)值差异,并采用受检者工作特征(ROC)曲线评价单独使用T_(1)、T_(2)值及二者联用对IDC分子亚型的鉴别诊断价值。结果79例患者共82个病灶中,Luminal A型16个(19.51%)、Luminal B1型11个(13.41%)、Luminal B2型27个(32.93%)、酪氨酸激酶受体-2过度表达型(Erb-B2过表达型)14个(17.07%)、三阴型(TNBC)14个(17.07%)。各分子亚型患者年龄、病灶分布、最大径、形态、边缘、强化表现差异均无统计学意义(P>0.05)。免疫组化指标中仅Ki-67阳性组T_(1)值高于阴性组(P<0.05)。ROC曲线分析显示,Ki-67阳性病灶T_(1)值临界值为2145 ms,约登指数为0.368,敏感度为53.47%,特异度为83.33%,曲线下面积(AUC)为0.640(95%CI:0.527~0.744)。Luminal A、Luminal B1、Luminal B2、Erb-B2过表达型、TNBC分子亚型间T_(1)、T_(2)值差异均无统计学意义(P>0.05),而Luminal型病灶T_(1)、T_(2)值均低于TNBC型(P<0.05)。ROC曲线分析显示,联合T_(1)、T_(2)值鉴别Luminal型/TNBC型的效能优于单独使用T_(1)、T_(2)值。结论T_(1)mapping可作为预测IDC肿瘤Ki-67高低表达程度的方法之一,联合使用T_(1)、T_(2)值可提高预测Luminal型/TNBC型的效能。Objective To explore the value of magnetic resonance relaxation time quantitative imaging in predicting molecular subtypes of invasive ductal carcinoma(IDC)of breast.Methods A total of 79 IDC patients underwent routine magnetic resonance imaging(MRI)scanning and relaxation time quantitative imaging.According to immunohistochemical results of lesions,patients were divided into different immunohistochemical index groups and molecular subtype groups.The differences in MRI signs,T_(1) values and T_(2) values of lesions were statistically compared between each group.Patient operating characteristic(ROC)curve was used to evaluate values of T_(1) and T_(2) alone and the combination of them in differential diagnosis of IDC molecular subtypes.Results There were 82 samples of lesion in 79 patients,in which,Luminal A type 16(19.51%),Luminal B1 type 11(13.41%),Luminal B2 type 27(32.93%),tyrosine kinase receptor-2 overexpression type(Erb-B2)14(17.07%)and TNBC 14(17.07%).There were no significant differences in patient age,lesion distribution,maximum diameter,morphology,margin and enhancement performance between patients with various molecular subtypes(P>0.05).Among the immunohistochemical indexes,only the Ki-67 positive group had higher T_(1) value than the negative group(P<0.05).In ROC analysis,the critical T_(1) value of Ki-67 positive lesions was 2145 ms,Yoden index was 0.368,the sensitivity was 53.47%,the specificity was 83.33%and the area under the curve(AUC)was 0.640(95%CI:0.527-0.744).There were no significant differences in T_(1) and T_(2) values between Luminal A,Luminal B1,Luminal B2,Erb-B2 enriched and TNBC subtypes(P<0.05).T_(1) and T_(2) values were lower in Luminal type lesion than those of TNBC type lesion(P<0.05).ROC curve analysis showed that the combined T_(1) and T_(2) values were more effective in differentiating Luminal/TNBC type than those of T_(1) and T_(2) values alone.Conclusion T_(1) mapping can be used as one of the methods to predict the high or low expression levels of Ki-67 in IDC tumors.The comb

关 键 词：乳腺肿瘤 癌 导管 乳腺 磁共振成像 弛豫时间定量成像 分子亚型 

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