DCE-MRI联合KDM6B、PD-L1在乳腺癌诊断及预后评估中的价值  

The value of DCE-MRI combined with KDM6B and PD-L1 in diagnosis and prognosis evaluation of breast cancer

作　　者：崔哲铭 许嘉琪 王甜甜 朱戈艺 王铁君[1] CUI Zheming;XU Jiaqi;WANGN Tiantian;ZHU Geyi;WANG Tiejun(Department of Radiotherapy,Bethune Second Hospital of Jilin University,Changchun,Jilin,China,130022;Department of Breast Surgery,the Second Hospital of Jilin University,Changchun,Jilin,China,130022)

机构地区：[1]吉林大学白求恩第二医院放疗科,吉林长春130022 [2]吉林大学第二医院乳腺外科,吉林长春130022

出　　处：《分子诊断与治疗杂志》2025年第2期221-225,共5页Journal of Molecular Diagnostics and Therapy

基　　金：吉林省自然科学基金(YDZJ202301ZYTS069)。

摘　　要：目的探讨动态增强磁共振成像(DCE-MRI)定量参数联合赖氨酸去甲基酶6B(KDM6B)、程序性死亡配体-1(PD-L1)在乳腺癌诊断与预后的应用价值。方法选择2019年10月至2020年10月吉林大学白求恩第二医院收治的83例乳腺癌患者作为观察对象(乳腺癌组),对患者进行随访,根据随访结果分为预后良好组与预后不良组,另选取同期在本院确诊的85例乳腺良性病变患者作为乳腺良性病变组,分析乳腺癌组与乳腺良性病变组DCE-MRI参数及KDM6B、PD-L1免疫组织化学染色结果,比较乳腺癌组织不同KDM6B、PD-L1蛋白表达状态的容量转移常数、速率常数、血管外间隙容积分数水平,分析DCE-MRI联合KDM6B、PD-L1对乳腺癌的诊断价值,采用一致性Kappa检验比较DCE-MRI、KDM6B、PD-L1单独及联合诊断乳腺癌与病理结果的一致性,采用受试者工作特征(ROC)曲线分析DCE-MRI、KDM6B、PD-L1单独及联合对乳腺癌诊断价值。结果乳腺癌组K^(trans)、Ke高于乳腺良性病变组,差异有统计学意义(P<0.05);乳腺癌组KDM6B、PD-L1阳性率显著高于良性病变组,差异有统计学意义(P<0.05);DCE-MRI、KDM6B单独与病理诊断一致性较好,Kappa值分别为0.656、0.461(P<0.05),DCE-MRI、KDM6B、PD-L1联合与病理诊断一致性为较高,Kappa值为0.717(P<0.05);DCE-MRI联合KDM6B、PD-L1诊断乳腺癌的敏感度为93.98%,特异度77.65%,准确度为85.71%。ROC曲线分析显示,DCE-MRI、KDM6B、PD-L1单独及联合诊断乳腺癌诊的曲线下面积(AUC)分别为0.828、0.731、0.622、0.882。预后不良22例,预后良好61例,预后不良组KDM6B、PD-L1阳性表达率高于预后良好组,差异有统计学意义(P<0.05);乳腺癌组织中KDM6B、PD-L1阳性表达与阴性表达间的K^(trans)、K_(ep)值比较差异有统计学意义(P<0.05)。结论乳腺癌组织中KDM6B、PD-L1呈阳性表达,与DCE-MRI定量参数及患者预后相关,DCE-MRI定量参数联合KDM6B、PD-L1对乳腺癌有一定诊断价值。Objective To investigate the value of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with lysine demethylase 6B(KDM6B)and programmed death ligand-1(PD-L1)in the diagnosis and prognosis of breast cancer.Methods A total of 83 patients with breast cancer admitted to Bethune Second Hospital of Jilin University from October 2019 to October 2020 were selected as the observation subjects(breast cancer group).These patients were followed up,and based on the follow-up results,they were divided into a good prognosis group and a poor prognosis group.Additionally,85 patients with benign breast lesions diagnosed in our hospital during the same period were selected as the benign breast lesions group.DCE-MRI parameters and immunohistochemical staining results of KDM6B and PD-L1 were analyzed in both the breast cancer group and benign breast lesions group.The levels of capacity transfer constant(K^(trans)),rate constant(K_(ep)),and extravascular space volume fraction(Ve)of different KDM6B and PD-L1 protein expression states in breast cancer tissues were compared.The value of DCE-MRI combined with KDM6B and PD-L1 in breast cancer diagnosis was also analyzed.The consistency Kappa test was used to compare the consistency of DCE-MRI,KDM6B,PD-L1 alone,and their combined diagnosis of breast cancer with pathological results.Receiver operating characteristic(ROC)curve analysis was used to determine the diagnostic value of DCE-MRI,KDM6B and PD-L1 in breast cancer alone and in combination.Results The K^(trans) and Ke values in the breast cancer group were higher than those in the benign breast disease group,and the difference was statistically significant(P<0.05).The positive rates of KDM6B and PD-L1 in the breast cancer group were significantly higher than those in the benign lesions group,with statistical significance(P<0.05).DCE-MRI and KDM6B alone showed good consistency with pathological diagnosis,with Kappa values of 0.656 and 0.461(P<0.05),respectively.The combination of DCE-MRI,KDM

关 键 词：乳腺癌 动态增强磁共振成像 赖氨酸去甲基酶6B 程序性死亡配体-1 

分 类 号：R73[医药卫生—肿瘤]