乳腺癌DCE-MRI表现特征与生物因子表达及淋巴结转移的相关性研究

目的探索乳腺癌动态增强磁共振成像(DCE MRI)表现特征与生物因子雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体 2(Her 2)、Ki 67表达状态及淋巴结转移的关系。方法选取2015年6月至2019年5月连云港市第一人民医院收治的经病理确诊为乳腺癌的80例患者(80个病灶),分析患者的DCE MRI特征:肿瘤直径、肿瘤形态、肿瘤边缘、强化方式、时间 信号强度曲线(TIC)及早期强化率(ΔSI)。采用免疫组织化学染色分析ER、PR、Her 2、Ki 67的表达情况。分析乳腺癌患者的DCE MRI表现特征与ER、PR、Her 2、Ki 67阳性表达状态及淋巴结转移之间的关系。结果直径≤2 cm、2 cm<直径≤5 cm及直径>5 cm肿瘤的PR阳性表达率组间差异具有统计学意义（P=0024）；形态为类圆形、分叶状及不规则形肿瘤的PR阳性表达率组间差异有统计学意义（P=0040）；直径>5 cm肿瘤发生淋巴结转移的概率较直径≤2 cm肿瘤及2 cm<直径≤5 cm肿瘤高（均P<005）。肿瘤边缘与Her 2表达水平呈正相关(r=0276,P=0013),早期强化率与Ki 67表达水平呈正相关(r=0254,P=0023)。结论乳腺癌DCE MRI表现特征在一定程度上可以初步评估乳腺癌细胞的生物学行为,为指导临床综合治疗及评估患者预后提供客观依据。

Correlation between DCE-MRI imaging features and expression of biological factors and lymph node metastasis in breast cancer

Objective To explore the relationship between dynamic enhanced magnetic resonance imaging (DCE-MRI) features of breast cancer and the expression of biological factors ER, PR, Her-2, Ki-67 and lymph node metastasis. Methods The preoperative DCE-MRI features, lymph node metastasis status and biological factors ER, PR, Her-2 and Ki-67 expression data of 80 lesions in 80 patients with pathologically diagnosed breast cancer were collected from the First People's Hospital of Lianyungang City from June 2015 to May 2019. DCE-MRI features of breast cancer including tumor size, lesion morphology, lesion margin, enhancement mode, time-signal intensity curve type (TIC) and early enhancement rate. Spearman rank correlation coefficient was used to analyze the correlation between the performance of DCE-MRI and the expression of ER, PR, Her-2, Ki-67 and lymph node metastasis. Results There was a positive correlation between the edge of the lesion and the positive expression level of Her-2 (r=0.276, P=0.013). The early enhancement rate was positively correlated with the positive expression level of Ki-67 (r=0.254, P=0.023). Tumor size and enhancement pattern were positively correlated with lymph node metastasis (r=0.365, 0.223, both P<0.05). Conclusion There is a correlation between the edge and early enhancement rate of breast cancer lesions and the expression status of EP, PR, Her-2, and Ki-67. In addition, there is a certain correlation between tumor size, enhancement mode and lymph node metastasis.The characteristics of DCE-MRI in breast cancer can provide objective guidance for the preliminary assessment of the biological behavior of breast cancer cells, guiding clinical comprehensive treatment and assessing the prognosis of patients.