乳腺癌患者的MRI影像学特点与病理类型、腋窝淋巴结转移及分子生物学标志物的关系  

Relationship between MRI imaging features and pathological types,axillary lymph node metastasis and molecular biomarkers in patients with breast cancer

作　　者：刘鹏 古丽依帕尔·买买提明 杨涛[1] 郭小会 Liu Peng;Guliyipaer Maimaitiming;Yang Tao;Guo Xiaohui(Department of Radiology,Beijing Daxing District People′s Hospital,Beijing 102600,China;Department of Radiology,Hetian County People′s Hospital,Hetian 848000,China)

机构地区：[1]北京市大兴区人民医院放射科,北京102600 [2]和田县人民医院放射科,和田848000

出　　处：《中国医师杂志》2025年第2期241-245,共5页Journal of Chinese Physician

基　　金：大兴区人民医院科研课题(4201937295)。

摘　　要：目的分析乳腺癌患者的磁共振成像(MRI)影像学特点与病理类型、腋窝淋巴结转移及分子生物学标志物的关系。方法回顾性分析北京市大兴区人民医院2021年1月-2022年11月间收治的50例乳腺癌患者(观察组)及50例乳腺良性病变患者(对照组)的临床资料;依照病理检查结果对乳腺癌患者病理类型进行分析,并记录乳腺癌患者腋窝淋巴结转移情况;对患者行MRI扫描检查并计算速率常数(Kep)、传输常数(K_(trans))、血管外细胞外间隙体积百分数(Ve)值;检测患者乳腺标本分子生物学标志物[雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)、增殖细胞核抗原(Ki-67)]表达水平。分析两组患者MRI影像学特点,分析不同病理类型、是否腋窝淋巴结转移、不同分子生物学标志物水平的乳腺癌患者MRI影像学特点。结果观察组患者Kep、K_(trans)、Ve均明显高于对照组(均P<0.01)。不同病理类型(浸润性导管癌、浸润性小叶癌及黏液癌)乳腺癌患者Kep、K_(trans)、Ve比较差异有统计学意义(均P<0.05),其中浸润性小叶癌患者Kep、K_(trans)、Ve最高,且差异有统计学意义(均P<0.05)。腋窝淋巴结转移患者Kep、K_(trans)、Ve明显高于未转移患者(均P<0.01)。ER阳性患者Ve低于ER阴性者,PR阳性患者Kep、Ve低于PR阴性者,HER-2阳性患者Kep高于HER-2阴性者,且Ve低于HER-2阴性者,Ki-67高表达患者Kep低于Ki-67低表达者,且Ve高于Ki-67低表达者,差异均有统计学意义(均P<0.05)。结论乳腺癌患者的MRI影像学特点与病理类型、腋窝淋巴结转移及分子生物学标志物有一定关系,临床中可通过MRI影像学特点对乳腺癌患者进行评估和分析。ObjectiveTo analyze the relationship between magnetic resonance imaging(MRI)and pathological type,axillary lymph node metastasis and molecular biomarkers in patients with breast cancer.MethodsThe clinical data of 50 patients with breast cancer(observation group)and 50 patients with benign breast lesions(control group)admitted to the Beijing Daxing District People′s Hospital from January 2021 to November 2022 were retrospectively analyzed.The pathological types of breast cancer patients were analyzed according to the pathological examination results,and the axillary lymph node metastasis of breast cancer patients was recorded.Reverse rate constant(Kep),transfer constant(K trans)and extravascular extracellular volume fraction(Ve)were calculated by MRI scanning.The expression level of molecular biomarkers of breast samples[estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER-2),Ki-67]were detected.MRI imaging characteristics of patients in the two groups were analyzed,and MRI imaging characteristics of breast cancer patients with different pathological types,axillary lymph node metastasis and different molecular biomarker levels were analyzed.ResultsKep,K trans and Ve in observation group were significantly higher than those in control group(all P<0.01).There were statistically significant differences in Kep,K trans and Ve among breast cancer patients with different pathologic types(invasive ductal carcinoma,invasive lobular carcinoma and mucinous carcinoma)(all P<0.05),and the highest Kep,K trans and Ve were found in invasive lobular carcinoma patients,and the differences were statistically significant(all P<0.05).Kep,K trans and Ve in patients with axillary lymph node metastasis were significantly higher than those without metastasis(all P<0.01).ER positive patients had lower Ve than ER negative patients,PR-positive patients had lower Kep than PR-negative patients,HER-2 positive patients had higher Kep than HER-2 negative patients,and Ve was lower than HER-2 negative patie

关 键 词：乳腺肿瘤 磁共振成像 淋巴转移 生物标记 

分 类 号：R73[医药卫生—肿瘤]