DCE-MRI参数与肿瘤新生血管的相关性的研究

Parameters of Dynamic Contrast-Enhanced MRI as Imaging Markers for Angiogenesis in Human Breast Cancer

目的:研究DCE-MRI(dynamic contrast-enhanced magnetic resconance imaging,DCE-MRI)参数与肿瘤新生血管的相关性。方法:应用3.0T磁共振仪对124例乳腺肿瘤患者行DCE-MR检查,经手术病理证实恶性59例;良性65例。并计算血流动力学参数K^(trans)、K_(ep)、Ve以及ADC(apparent diffusion cofficient,ADC)值。运用Person检验分析磁共振各参数值与CD31、CD105表达的微血管密度(MVD)之间的相互关系,以及与细胞增殖Ki-67的相关性。结果:K^(trans)、K_(ep)以及ADC值在恶、良性病变、正常腺体组之间两两比较有统计学差异,K^(trans)、K_(ep)值在恶性病变组最高,高于正常组织、良性病变组(P<0.05)。而Ve值正常腺体、良性病变以及正常腺体组与恶性病变组两两比较有统计学意义(P<0.05),良性病变与恶性病变组比较无统计学差异(P>0.05)。并且K^(trans)和K_(ep)值在浸润性导管癌和导管原位癌组明显高于不典型增生组(P<0.001)。相反ADC值浸润性癌和导管原位癌低于不典型增生(P<0.001)。而Ve值在各组间无统计学差异(P>0.05)。另外CD105、Ki-67与磁共振参数K^(trans)、K_(ep)和ADC值之间具有相关性(P<0.05,r=0.563,r=-0.566)。结论:DCE-MRI成像中K^(trans)、K_(ep)和ADC值可以定量评估乳腺癌微血管密度。

Objective： Breast cancer is the most common malignancy and the leading cause of cancer death in women worldwide; yet, early diagnosis has been difficult due to its complex pathological structure. This study evaluated the value of morphological examination in conjunction with dynamic contrast-enhanced MRI （DCE-MRI） for more precise diagnosis of breast cancer, as well as their correlation with angiogenesis and proliferation biomarkers. Methods： DCE-MRI parameters （including Kmms, Kes Vc, and ADC） were obtained from 124 patients with breast cancer （128lesions）. Microvessel density （MVD） was evaluated by the immunohistochemical analysis of tumor vessels for CD31 and CD105 expression.The proliferation was assessed by analyzing Ki67. Results： Ktrans values were in the order of malignant lesions 〉 normal glands 〉 benign lesions. Similar results were observed for I~,. The opposite changes were seen with Ve. Ktrms and Kep values were significantly higher in invasive ductal carcinoma （IDC） and duetal carcinoma in situ （DCIS） than in mammary ductal dysplasia. In sharp contrast, ADC values were lower in IDC and DCIS than in MDD, and Vo was not significantly different among the three groups. In addition, expression of CD105 and Ki67, the commonly recognized markers for angiogenesis and proliferation, respectively, were closely correlated with MRI parameters as revealed by Pearson analysis. Conelusiom： Determination of Ktrans, Kep and ADC values permits estimation of tumor angiogenesis and proliferation in breast cancer and DCE-MRI parameters can be used as imaging biomarkers to predict the biologic aggressiveness of the tumor and patient prognosis.