磁共振弥散加权成像对乳腺癌分子分型的诊断效能  

Diagnostic efficiency of magnetic resonance diffusion weighted imaging in molecular typing of breast cancer

作　　者：周鹏 刘建军 江文婷 ZHOU Peng;LIU Jianjun;JIANG Wenting(Department of Imaging,Shangrao People’s Hospital,Shangrao 334000,Jiangxi,China)

机构地区：[1]上饶市人民医院影像科,江西上饶334000

出　　处：《癌症进展》2025年第2期210-213,221,共5页Oncology Progress

摘　　要：目的探究磁共振弥散加权成像(DWI)对乳腺癌分子分型的诊断效能。方法选取80例行MRI检查并确诊为乳腺癌的患者,根据病理结果分为管腔上皮(Luminal)A型26例,Luminal B型29例,人表皮生长因子受体2(HER2)过表达型10例,三阴性乳腺癌(TNBC)型15例。比较不同分子分型乳腺癌患者的表观弥散系数(ADC),采用受试者工作特征(ROC)曲线评估DWI对乳腺癌分子分型的诊断效能。结果b值为800s/mm^(2)时,不同分子分型乳腺癌患者ADC值比较,差异无统计学意义(P>0.05)。b值为1000s/mm^(2)时,不同分子分型乳腺癌患者ADC值比较,差异有统计学意义(P<0.01)。以病理结果为金标准,b值为1000 s/mm^(2)时,ADC值诊断Luminal A型的灵敏度、Luminal B型的特异度均低于b值为800 s/mm^(2)时,其余各分子分型的特异度、灵敏度、阴性预测值和阳性预测值均高于b值为800 s/mm^(2)时,TNBC型在两个b值下均有较高的特异度和灵敏度。b值为1000 s/mm^(2)时,ADC诊断TNBC型乳腺癌的曲线下面积(AUC)为0.667(95%CI:0.553~0.769),约登指数为0.379,特异度为0.446,灵敏度为0.933。结论DWI对乳腺癌分子分型具有良好的诊断效能。Objective To explore the diagnostic efficacy of magnetic resonance diffusion weighted imaging(DWI)in molecular typing of breast cancer.Method A total of 80 patients diagnosed with breast cancer underwent MRI,and were divided into Luminal A type(26 cases),Luminal B type(29 cases),human epidermal growth factor receptor 2(HER2)over expression type(10 cases),and triple-negative breast cancer(TNBC)type(15 cases)according to pathological findings.The apparent diffusion coefficient(ADC)of patients with different molecular types of breast cancer was compared,and receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency of DWI for breast cancer molecular typing.Result When b value was 800 s/mm^(2),there was no significant difference in ADC value between different molecular types of breast cancer patients(P>0.05).When b value was 1000 s/mm^(2),ADC values of different molecular types of breast cancer patients were compared,and the difference was statistically significant(P<0.01).When b value was 1000 s/mm^(2),the sensitivity of ADC value to diagnose Luminal A type and the specificity of Luminal B type were lower than those of the b value of 800 s/mm^(2),and the rest specificity,sensitivity,negative predictive value and positive predictive value of ADC value for the diagnosis of various molecular types were higher than those at b value of 800 s/mm^(2),and TNBC type had higher specificity and sensitivity under both b values.When b value was 1000 s/mm^(2),the area under the curve(AUC)of ADC for the diagnosis of TNBC was 0.667(95%CI:0.553-0.769),the Youden index was 0.379,the specificity was 0.446,and the sensitivity was 0.933.Conclusion DWI has good diagnostic efficacy for molecular staging of breast cancer.

关 键 词：磁共振弥散加权成像 乳腺癌 分子分型 诊断效能 表观弥散系数 受试者工作特征曲线 

分 类 号：R737.9[医药卫生—肿瘤]