乳腺癌MRI表现与免疫组化相关性的初步研究

目的:探讨乳腺癌的ER、PR、CerbB-2、VEGF表达与MRI征象之间的关联性。方法:对50个乳腺癌患者术前行乳腺MR扫描,分析乳腺癌的MRI影像学表现,术后标本行免疫组织化学染色测定肿瘤细胞ER、PR、CerbB-2、VEGF表达情况,并分析与相应病灶MRI表现的关系。结果:乳腺癌的MRI多表现为形态不规则、分叶状或类圆形结节,边缘毛刺,边界模糊,部分病灶内部见坏死;大部病灶在T1WI呈略低信号,在脂肪抑制T2WI呈不均匀高信号;Gd-DTPA增强扫描后,呈明显均匀或不均匀强化、斑驳样强化或边缘环形强化。乳腺癌病灶早期边缘强化与癌细胞VEGF阳性表达呈显著正相关(r=0.873;P0.01);毛刺状边缘与ER、PR、VEGF阳性表达呈正相关(r=0.702,0.764,0.497;P0.05);内部坏死与CerbB-2阳性表达呈显著正相关(r=0.718;P0.01);形态与癌细胞ER、PR、CerbB-2、VEGF表达情况无显著相关性(r=0.129,0.312,0.343,0.254;P0.05)。结论:乳腺癌MRI征象与免疫组化标记物之间存在一定的相关性,对我们从影像角度评估乳腺癌的生物学行为和预后有一定的参考价值。

Relation of MRI features and the expression of immunohistochemistry in breast cancer

Objective：To investigate the correlativity between magnetic resonance imaging morphological features and the expression of ER,PR,CerbB-2 and VEGF in breast cancer.Methods：MR scanning was performed on 50 patients with breast cancer before operation.The MRI morphological features of breast cancer were analyzed.ER,PR,CerbB-2 and VEGF expression of the specimens of the patients with breast cancer after mastectomy were determined by immunohistochemistry.The relationship between the immunohistochemical results and the MRI morphological features was analyzed.Results：Irregular shape,round nodule or spiculated margin,obscure margin and necrotic center were found more frequently on plain MRI in patients with breast cancer.Most of the signs with lower signal in T1WI and high signal in T2WI fat-suppressed;marked homogeneous or inhomogeneous enhancement or early enhancement of edge after injection of Gd-DTPA.VEGF positive expression was positively correlated with early enhancement of edge（r=0.873;P0.01）;ER,PR,VEGF positive expression was positively correlated with spiculated margin and obscure margin（r=0.702,0.764, 0.497;P0.05）;CerbB-2 positive expression was positively correlated with necrotic center of breast cancer（r=0.718;P0.01）;but the expression of ER,PR,CerbB-2,VEGF were not significantly correlated with morphology of breast cancer（P0.05）.Conclusion：There is correlation between MRI morphological features and the expression of ER,PR,CerbB-2 and VEGF of breast cancer to a certain degree.MRI features can reflect the biologic behavior and prognosis of breast cancer,which can provide evidence for clinical treatment planning of breast cancer.