ADC值与乳腺浸润性导管癌恶性程度相关性分析

目的探讨雌激素受体阳性乳腺浸润性导管癌的表观扩散系数(ADC)值与肿瘤间质比、肿瘤大小及肿瘤分级的相关性。方法回顾性纳入术前行乳腺DWI和增强MRI扫描检查并经病理确诊为雌激素受体阳性乳腺浸润性导管癌的70例女性病人,年龄29~76岁,平均(49.58±6.81)岁。依据病理结果将病灶分为富间质型组和少间质型组,记录每个病灶的间质比并进行病理分级。在增强MRI影像上测量病灶最大直径,计算肿瘤ADC值。采用t检验、卡方检验和Mann-Whitney U检验分别比较2组间肿瘤最大直径、肿瘤分级及ADC值的差异。采用Spearman相关分析ADC值与肿瘤侵袭、恶性程度的相关性。结果富间质型组29例,少间质型组41例。2组间肿瘤分级的差异有统计学意义(P<0.05)。与少间质型组相比,富间质型组的最大直径更小,而ADC值更大(均P<0.05)。肿瘤最大直径、间质比及分级均与ADC值呈负相关(分别rs=-0.651,rs=-0.636,rs=-0.451,均P<0.05)。结论乳腺浸润性导管癌的ADC值与肿瘤直径、肿瘤间质比和肿瘤分级密切相关,能较好地反映肿瘤的恶性程度。

Relationship between apparent diffusion coefficient and malignancy of invasive ductal carcinoma

Objective To explore the relationship between the apparent diffusion coefficient(ADC)and the tumorstromal ratio,tumor size,and tumor grades in estrogen receptor-positive breast invasive ductal carcinoma.Methods Seventy female patients with pathologically confirmedestrogen receptor-positive breast invasive ductal carcinomawere retrospectively included in this study(mean age 49.58±6.81 years,range 29-76 years).The preoperative breast DWI and enhanced MRI data of were acquired from each patient.The patients were divided into the rich and poor interstitial groups according to the pathological results.The interstitial ratio of each lesion was recorded,and the pathological classification were conducted.The maximum diameter of the lesion was measured on enhanced MRI images,and the ADC of the tumor was calculated.Maximum diameters,tumor grades,and ADCs of lesions were compared between the two groups by using twosample t test,Chi-square test,and Mann-Whitney U test respectively.Spearman’s correlation analysis was used to analyze the correlation between ADC,the invasion,and malignant degree,while regression analysis was used to determine the independent correlation variates with ADC.Results There was significant difference in tumor grade between the stroma poor group(n=41)and stroma rich group(n=29)(P<0.05).The maximum diameter of stroma of rich group was smaller,and the ADC was larger than that of the stroma poor group(all P<0.05).The tumor-stroma ratio,maximum diameter,and tumor grade negatively correlated with ADC(rs=-0.651,rs=-0.636,rs=-0.451,respectively,all P<0.05).Conclusion The ADC of breast invasive ductal carcinoma is significantly correlated with the size,tumor-stroma ratio and grades of the lesions,and can well reflect histopathological information.