乳腺浸润性导管癌3.0TMRI表现与预后因子相关性研究

目的：探讨乳腺浸润性导管癌磁共振表现与生物学预后因子间的相关性。材料与方法对128例原发性乳腺浸润性导管癌患者术前行MR扫描，根据MRI乳腺影像报告和数据系统描述乳腺癌的MR表现。术后标本行免疫组化染色测定ER、PR、Her-2、Ki67的表达情况，采用Spearman等级相关和二元Logistic回归统计学方法分析其与MRI表现参数的相关性。结果肿瘤分叶征和Ki67表达呈负相关（P=0.014）；环形强化和ER、PR表达呈明显负相关（P=0.002，P=0.016）；Ⅲ型时间信号强度曲线和Ki67表达显著正相关（P=0.012）。结论乳腺浸润性导管癌MR表现参数与生物学预后因子之间存在一定相关性，可根据MR表现对病灶的生物学行为和患者预后进行评估。肿瘤环形强化和Ⅲ型曲线常提示患者预后不良。

Relationships between 3.0 T MRI features and prognostic factors of patients in breast invasive ductal carcinoma

Objective：The aim of the current study was to correlate Magnetic resonance features with prognostic factors in breast invasive ductal carcinoma. Materials and Methods： 128 cases with primary breast invasive ductal carcinoma underwent magnetic resonance prior to surgery. Magnetic resonance features of breast cancer were determined based on the Breast Imaging and Reporting Data System （BI-RADS）. MRI characteristics of our study included tumor shape, margin, type of enhancement, time to peak （Tpeak）, Signal enhancement ratio （SER）, Time intensity curve （TIC） and apparent diffusion coefifcient （ADC）, rADC. Histological specimens were analyzed after surgery for expression of estrogen receptor （ER）, expression of progesterone receptor （PR）, and expression of Her-2, Ki-67. These patients were all women, the mean age of them was 49＆#177;9.6 （ranging 28 to 76 years）. All the patients had exactly the same MR sequences and parameters. The MRI scans were acquired with the patient prone position in a 3.0 T scanner （Magnetom Verio, Siemens Medical Solutions, Erlangen, Germany） equipped with a dedicated surface breast coil. All images were obtained in a workstation. Two breast radiologists retrospectively analyzed the imaging ifndings, and any discrepancy was resolved by consensus. Correlations between the MR features and prognostic factors were analyzed using the Spearman rank correlation. Logistic regression was performed for the analysis Spearman rank correlations to identify the most signiifcant and independent MR image ifndings that were correlated with the prognostic factors. The above-mentioned statistical analyses were performed with SPSS 19.0. Results：Statistical analysis showed that Lobulate was associated with the negative expression of Ki67 （P=0.014）.The rim enhancement of the mass was also associated with negative expression of ER （P=0.002）, negative expression of PR （P=0.016）. There was a signiifcant association between the type III of TIC and the expression of Ki67 （P=0.012）. Conclusions：To a certain extent there is some correlation among the MRI features, pathology, and prognostic factors in breast invasive ductal carcinoma. The biological behavior and prognosis of breast invasive ductal carcinoma be assessed based on MRI features. Lobulate shape,rim enhancement and the type III of TIC of the breast invasive ductal carcinoma were associated with a poor prognosis.