不同分子亚型乳腺癌的MR表现

目的 探讨不同分子亚型的乳腺癌磁共振（magnetic resonance，MR）表现的差异性。方法 回顾性分析经病理证实的69例乳腺癌患者的术前乳腺MR资料，通过分析MR形态学特征、早期强化率、时间信号强度曲线（time-signal intensity curve，TIC）以及表观扩散系数（apparent diffusion coefficient，ADC）值，对病变进行联合评价。结果 69例乳腺癌患者中，共有62例患者（76个病灶）呈肿块样强化病变，其中Luminal A型乳腺癌8例（11个病灶），Luminal B型乳腺癌35例（44个病灶），HER-2过表达型乳腺癌9例（11个病灶），三阴性乳腺癌10例（10个病灶）。肿块样强化病变中，不同分子亚型乳腺癌的形态差异有统计学意义（χ²=17.006，P=0.002），其中三阴性乳腺癌形态表现为圆形的比例明显大于其他三组乳腺癌（40.00% vs 10.61%，χ²=6.390，P=0.033）；不同分子亚型乳腺癌的边缘差异亦有统计学意义（χ²=25.502，P=0.001），其中三阴性乳腺癌边缘清晰比例显著大于其他三组乳腺癌（60.00% vs 10.61%，χ²=14.942，P=0.001）；不同分子亚型乳腺癌的内部强化方式、早期强化率、TIC类型及ADC值的差异无统计学意义（P＞0.05）。。结论 不同分子亚型乳腺癌MR表现上有一定区别，可能有助于区分三阴性乳腺癌和非三阴性乳腺癌，但目前尚不能依据MR表现乳腺癌分子亚型直接预测。

MR manifestation of different molecular subtypes of breast cancer

Objective To explore the differences in magnetic resonance（MR） manifestation of different molecular subtypes of breast cancer. Methods MR images from 69 breast cancer patients were retrospectively analyzed. The morphological characteristics，early enhancement rate，time-signal intensity cure（TIC） and apparent diffusion coefficient（ADC） value of the breast cancer lesions with each molecular subtype were identified and assessed jointly. Results Among 69 cases of breast cancer，62 cases（76 lesions） showed mass-like enhancement lesions，including 8 cases of Luminal A breast cancer（11 lesions），35 cases of Luminal B breast cancer（44 lesions），9 cases of HER-2 overexpression breast cancer（11 lesions） and 10 cases of triple-negative breast cancer（10 lesions）. In mass-like enhancement lesions，the morphological difference of different molecular subtypes of breast cancer cells was statistically significant（χ²=17.006，P=0.002），and the proportion morphology of round of triple-negative breast cancer was significantly larger than the other three groups（40.00% vs 10.61%，χ²=6.390，P=0.033）. The marginal difference of different molecular subtypes of breast cancer cells was also statistically significant （χ²=25.502，P=0.001），and the proportion of circumscribed margin of triple-negative breast cancer was significantly greater than the other three groups（60.00% vs 10.61%，χ²=14.942，P=0.001）. There were no significant differences in internal enhancement characteristics，early enhancement rate，TIC type and ADC value among different molecular subtypes of breast cancer（P>0.05）. Conclusions Different molecular subtypes of breast cancer have some differences in MR manifestation，which may help distinguish between triple-negative breast cancer and non-triple-negative breast cancer. However，there is not currently possible to directly predict the molecular subtype of breast cancer based on MR manifestation.