乳腺导管内原位癌的MRI特征与HER-2表达的相关性分析

目的 探讨乳腺导管内原位癌（DCIS）的MRI特征与HER-2表达的相关性。方法 回顾性分析2018年9月—2021年6月在德州市第二人民医院经手术病理证实的53例乳腺DCIS患者分为HER-2阳性组29例，HER-2阴性组24例，比较2组间MRI特征的差异。结果 2组间内部强化特征、微血管征、TIC类型差异有统计学意义（P < 0.05）；病灶形态学、非肿块样强化分布形式、ADC值差异无统计学意义（P > 0.05）。HER-2阳性组以集群状强化（65.5%）为主，TIC类型以Ⅱ型（48.1%）、Ⅲ型（29.6%）为主，微血管征（89.7%）；HER-2阴性组以簇环状强化（50.0%）为主，TIC类型以Ⅱ型（45.8%）、Ⅰ型（54.2%）为主，微血管征（54.2%）；集群状强化，微血管征、TIC Ⅲ型3个参数同时具备诊断HER-2阳性的特异度及阳性预测值均为100%。结论 MRI参数中集群状强化、微血管征及TIC Ⅱ型或Ⅲ型曲线在较大程度上能反映 乳腺DCIS中HER-2表达情况，三者联合应用可提高HER-2阳性的诊断效能。

Analysis of the correlation between MRI features and HER-2 expression inductal carcinoma in situ

Objective To investigate the correlation between the features of multimodal magnetic resonance imaging (MRI) and the expression of human epidermal growth factor receptor-2 (HER-2) in ductal carcinoma in situ (DCIS). Methods A total of 53 patients with DCIS confirmed by surgery and pathology in Dezhou Second People’s Hospital from September 2018 to June 2021 were analyzed retrospectively. The patients were divided into HER-2 positive group (29 cases) and HER-2 negative group (24 cases). MRI features were compared between the two groups. Results There were significant differences in the internal enhancement characteristics, microvascular sign, and time-intensity curve type between the two groups (P < 0.05). There were no significant differences in lesion morphology, non-mass-like enhancement pattern, and apparent diffusion coefficient value (P > 0.05). The HER-2 positive group showed clumped enhancement (65.5%), type Ⅱ (48.1%) andtype Ⅲ (29.6%) time-intensity curves, and microvascular sign (89.7%). The HER-2 negative group showed clusteredring enhancement (50.0%), type Ⅱ (45.8%) and type I (54.2%) time-intensity curves, and microvascular sign (54.2%). A combination of clumped enhancement, microvascular sign, and type Ⅲ time-intensity curve showed 100% specificity and 100% positive predictive value for the diagnosis of HER-2 positive DCIS. Conclusion Clumped enhancement, microvascular sign, and type Ⅱ or Ⅲ time-intensity curve on MRI can largely reflect the expression of HER-2 in DCIS. The three can be used in combination to improve the diagnostic efficiency of HER-2 positive DCIS.