基于联合DCE-MRI灌注参数、ADC值和临床特征模型对HER-2过表达型乳腺癌的诊断价值  

Diagnostic value of combining DCE-MRI perfusion parameters,ADC value and clinical feature model for HER-2 over expressed breast cancer

作　　者：陈寿让 杨志企[1,2,3] 陈漪 岳博文 程亚宝 范伟雄[1] 陈小凤[1,2,3] CHEN Shourang;YANG Zhiqi;CHEN Yi;YUE Bowen;CHENG Yabao;FAN Weixiong;CHEN Xiaofeng(Department of Radiology,Meizhou People’s Hospital,Meizhou,Guangdong Province 514031,China;Meizhou Clinical College of Shantou University Medical College,Meizhou,Guangdong Province 514031,China;Guangdong Engineering Technological Research Center of Clinical Molecular Diagnosis and Antibody Drugs,Meizhou,Guangdong Province 514031,China)

机构地区：[1]梅州市人民医院影像科,广东梅州514031 [2]汕头大学医学院梅州临床学院,广东梅州514031 [3]广东省临床分子诊断与抗体药物工程技术研究中心,广东梅州514031

出　　处：《实用放射学杂志》2024年第7期1083-1086,1110,共5页Journal of Practical Radiology

基　　金：广东省医学科研基金项目(B2021280);梅州市人民医院培育项目(PY-C2022011)。

摘　　要：目的探讨基于联合动态对比增强磁共振成像(DCE-MRI)灌注参数、表观扩散系数(ADC)值和临床特征模型对人表皮生长因子受体-2(HER-2)过表达型乳腺癌的诊断效能。方法回顾性分析197例行DCE-MRI及扩散加权成像(DWI)检查乳腺癌患者资料,其中HER-2过表达型乳腺癌47例,非HER-2过表达型乳腺癌150例。HER-2过表达型乳腺癌与非HER-2过表达型乳腺癌组间DCE-MRI灌注参数[容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积分数(Ve)、流入浓度增强率(W-in)、流出浓度衰减率(W-out)、达峰时间(TTP)]、ADC值和临床病理特征比较采用t检验或卡方检验。采用受试者工作特征(ROC)曲线分析模型诊断效能。结果HER-2过表达型乳腺癌和非HER-2过表达型乳腺癌组间肿瘤最大径、短径、T分期、N分期、Kep、W-in和ADC值的差异均有统计学意义(P<0.05)。联合肿瘤最大径、短径、T分期、N分期、Kep、W-in、ADC值构建的临床-影像联合模型曲线下面积(AUC)(AUC=0.763)高于基于联合最大径、短径、T分期、N分期的临床模型(AUC=0.634)和基于联合Kep、W-in、ADC值的影像模型(AUC=0.715)。结论肿瘤最大径、短径、T分期、N分期、Kep、W-in、ADC值与HER-2过表达型乳腺癌相关,联合上述参数可以提高诊断HER-2过表达型乳腺癌的能力。Objective To investigate the diagnostic efficiency of patients with human epidermal growth factor receptor-2(HER-2)over expressed breast cancer via combining the dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)perfusion parameters,apparent diffusion coefficient(ADC)value and clinical feature model.Methods A total of 197 breast cancer patients who underwent DCE-MRI and diffusion weighted imaging(DWI)scans were analyzed retrospectively,including 47 breast cancer patients with HER-2 over expressed and 150 breast cancer patients with non-HER-2 over expressed.The t-test or chi-square test was used to compare the DCEMRI perfusion parameters[Ktrans,Kep,Ve,W-in,W-out,and time to peak(TTP)],ADC value,and clinical feature between the two groups.The diagnostic efficiency of the models were analyzed via receiver operating characteristic(ROC)curves.Results There were significant difference in the maximum tumor diameter,minimum tumor diameter,T stage,N stage,Kep,W-in,and ADC value between HER-2 over expressed breast cancer and non-HER-2 over expressed breast cancer groups(P<0.05).The proposed combined model,which included the combined maximum tumor diameter,minimum tumor diameter,T stage,N stage,Kep,W-in,and ADC value,showed a better diagnostic efficiency with area under the curve(AUC)(AUC=0.763)than the clinical model(AUC=0.634)based on the combined maximum tumor diameter,minimum tumor diameter,T stage,and N stage,and the imaging model(AUC=0.715)based on the combined Kep,W-in and ADC value.Conclusion The maximum tumor diameter,minimum tumor diameter,T stage,N stage,Kep,W-in,and ADC value may be associated with HER-2 over expressed breast cancer.Combining all above parameters can improve the diagnostic ability of breast cancer patients with HER-2 over expressed.

关 键 词：乳腺癌 人表皮生长因子受体-2 动态对比增强磁共振成像 表观扩散系数 

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