乳腺癌MRI征象及其与免疫组化CerbB-2和Ki-67表达的相关性分析

目的总结乳腺癌患者的MRI征象特点并探析其与免疫组化Cerb B-2和Ki-67表达之间相关性。方法纳入我院2013年7月-2015年10月所收治经手术病理证实的乳腺癌患者62例作为研究对象,均行MRI检查,用甲醛固定标本并于病理诊断后进行免疫组织化学染色,记录Ki67与cerb B-2阳性率。结果 62例乳腺癌患者中MRI共诊断57例,诊断准确率为91.9%,4例(6.5%)误诊、1例(1.6%)漏诊。MRI表现:肿块影57例(46例肿块呈团块状或分叶状,边界模糊;11例呈小结节状、边界模糊)。T1WI以等信号、T2WI以高信号为主。增强扫描病灶多呈不均匀强化。62例患者中,43例(69.4%)MRI示同侧腋窝淋巴结信号强度均匀、19例(30.6%)示同侧腋窝淋巴结信号强度不均匀,提示发生淋巴结转移,淋巴结形态多不规则、边缘清楚。结论乳腺癌患者MRI征象以肿块影、边界模糊、T1WI等信号、T2WI高信号、增强扫描呈不均匀强化为主,可作为首选检查手段,同时在出现以上MRI征象前提下若发生Ki67或cerb B-2阳性表达,则应警惕淋巴结转移可能,需积极监测预后。

Analysis of the Correlation between MRI Findings and Expression of Immunohistochemical CerbB-2 and Ki-67 in Breast Cancer

Objective To summarize the MRI findings of patients with breast cancer and to analyze the correlation between findings and the expression of immunohistochemical CerbB-2 and Ki-67.Methods 62 cases of patients with breast cancer who were confirmed by surgery and pathology in our hospital between July 2013 and October 2015 were included in the study. All performed MRI examination.The specimens were fixed with formalin and after pathological diagnosis, immunohistochemical staining was performed. The positive rates of Ki67 and cerbB-2 were recorded.Results In 62 cases of patients with breast cancer, 57 cases were diagnosed by MRI and the diagnostic accuracy rate was 91.9%. 4 cases (6.5%) were misdiagnosed and 1 case (1.6%) was missed diagnosed. The MRI findings showed that there were mass shadows in 57 cases (46 masses were lumpy or lobulated, with fuzzy boundaries; 11cases were small nodular, with fuzzy boundaries). It showed isointense signal on T1WI and high signal on T2WI. After enhanced scan, lesions showed inhomogeneous enhancement. In 62 patients, MRI findings of 43 cases (69.4%) showed homogeneous ipsilateral axillary lymph node signal strength and 19 cases (30.6%) showed inhomogeneous ipsilateral axillary lymph node signal strength, suggesting there was lymph node metastasis. The shapes of lymph nodes were irregular in shape, with clear edges.Conclusion MRI findings of patients with breast cancer are characterized by mass shadow, fuzzy boundary, isointense signal on T1WI, high signal on T2WI and enhanced scan showinf inhomogeneous enhancement, which can be taken as the preferred examination means. Under the premise of MRI findings mentioned above, there exists positive expression of Ki67 or CerbB-2, doctors should be alert to lymph node metastasis and actively monitor the prognosis.