乳腺癌磁共振诊断表现与特异受体表达和微血管密度特征的相关性研究

MRI in the diagnosis of breast cancer and the correlation between expression of specific receptors and MVD

目的:探讨乳腺癌磁共振成像(MRI)诊断表现与特异受体表达和微血管密度(microvessel density,MVD)特征的相关性。方法:收集80例本院乳腺外科于2011年2月至2015年5月收治的经病理证实的原发性乳腺癌患者(均为单侧乳腺癌病灶)的临床资料。所有患者行MRI检查,术后对组织标本行免疫组化检测。观察乳腺癌的MRI表现、特异受体表达及MVD特征。结果:80例肿瘤中40例边缘呈毛刺状(50.0%),30例轮廓不规则(37.5%),10例呈分叶状(12.5%);10例边界轮廓清晰(12.5%),6例轮廓部分模糊(7.1%),64例边界完全模糊、与周围组织粘连、不清楚(80.0%);51例(63.75%)内部呈现坏死病灶,表现为长T1长T2信号,增强扫描无显著强化现象;乳腺癌边缘是否毛刺状与ER、Ki-67受体表达阳性率呈正相关,肿瘤内部是否坏死及其均匀性与C-erb B-2、P53及Her-2受体表达相关,乳腺癌患者MRI下毛刺状和非毛刺状以及癌不同部位之间的MVD均存在统计学差异(P<0.01),动态增强参数早期强化率、Tmax和曲线类型与MVD具有强烈的相关性。结论:乳腺癌MRI表现可在一定程度上反映乳腺癌组织的特异受体表达情况和血管生成情况,对临床治疗方案的选择、疗效监测和预后具有指导意义。

Objective： To evaluate the correlation of diagnostic performance of MRI in breast cancer with the expression of specific receptors and the characteristics of microvessel density（ MVD）. Methods： Records of 80 cases of patients with pathologically proven primary breast cancer,which were unilateral ones,were reviewed from February 2011 to May 2015 in our institution. All cases were evaluated by MRI preoperatively and tissue samples were collected for immunohistochemistry postoperatively. The signal of MRI,the expression of specific receptors and the characteristics of MVD were observed. Results： Of all the 80 tumors,there were 40 cases of burr-like edges（ 50. 0%）,30 cases of irregular contours（ 37. 5%）,10 cases of lobulated shape（ 12. 5%）; 10 cases of clear boundary contour（ 12. 5%）,6 cases of partial fuzzy boundary（ 7. 1%）,64 cases of completely fuzzy boundaries with the surrounding tissue adhesion（ 80. 0%）; 51 cases of presented internal necrotic lesions（ 63. 75%）,with long T1 and T2 signal and no significant enhancement sweep surface intensification; For the correlations analysis,burr-like edge of breast cancer was found to be correlated with ER,Ki-67 receptor expression; tumor necrosis and internal uniformity were found to be correlated with C-erb B-2,P53 and Her-2 receptor expression. There was a significant difference of MVD between burr-like and smooth edge timors as well as between different parts of cancer MVD with MRI diagnosis（ P〈0. 01）; Dynamic enhancement parameters early intensive rate,Tmax and curve type showed strong correlation. Conclusion： Diagnostic performance of MRI in breast cancer may reflect the expression of specific receptors and the condition of MVD to some extent,and may provide a guide to clinical treatment options,treatment monitoring and prognosis.