磁共振成像动态增强对乳腺癌血管生成的研究

Angiogenesis and Dynamic Contrast Enhanced MRI of Breast Cancer:Preliminary Results

目的:研究乳腺癌组织中微血管密度(MVD)及其分布、乳腺癌动态增强磁共振成像强化、腋淋巴结转移之间的相关性。方法:38例乳腺癌病例,手术前均行动态增强磁共振成像检查观察病灶中心、边缘的早期强化率(ΔSI)以及强化表现。对术后病理证实的乳腺癌31例,以正常乳腺组织为对照,采用免疫组化法检测MVD值在肿瘤中心及其边缘的分布,分析MRIΔSI与MVD的相关性。根据MRI乳腺癌的强化表现分为边缘强化组、非边缘强化组,结合各组腋窝淋巴结转移率,分析乳腺癌不同MRI强化形式与预后的关系。结果:乳腺癌MVD边缘>MVD中心,ΔSI边缘>ΔSI中心。ΔSI随MVD值增高,ΔSI与MVD值有明显相关性。MRI边缘强化的11例,病灶边缘部分MVD高于中心部分,差异有显著性意义(P<0.01),非边缘性强化组20例,虽然病灶边缘部分MVD高于中心部分,但二者差异无显著性意义。边缘强化组淋巴结转移率为72%(8/11),非边缘强化组淋巴结转移率为35%(7/20),差异有显著性意义(P<0.01)。结论:MVD值的大小和分布与MR动态增强早期强化率和强化均匀性密切相关,在一定程度上反映了乳腺肿瘤血管生成特性及其预后。

Objective: To explore the relationship between dynamic contrast enhanced MRI of early enhancement rate, enhancement pattern, metastases of axillary nodes and the microvascular density(MVD) in breast cancer. Methodes: Dynamic contrast-enhanced MR imaging of breast was performed in 38 cases (31 cases were breast cancer verified by pathology). Early enhanced rate(ΔSI) and enhanced feature of breast cancer were studied on MR imaging. The MVD in both the center and the peripheral of the lesions were acquired through SP immunohistochemical technique. Metastases of axillary nodes were confirmed by pathology. Results: The study shows that the distribution of MVD was heterogeneous, and the ΔSI became higher and lower with the changes of MVD, showed closed association with MVD(r=0.882-0.886). In cases the greater MVD was most frequently observed at the marginal region of breast cancer (P<0.01), while the peripheral enhancement can be observed on MR imaging. In non-peripheral-enhancement cases on MR, there was no significance difference in MVD between the center and the marginal. Higher incidence of metastases of axillary node was happened in peripheral-enhancement cases(72% 8/11) than in non-peripheral-enhancement cases(35% 7/20). (P<0.01). Conlusion: MR enhancement shows a high relativity with MVD, and as a noninvasive method, it has potential role in estimating the degree of agiogenesis of breast neoplasm.