定量动态增强磁共振成像预测乳腺癌分子亚型的价值

Association between quantitative parameters of DCE-MRI and molecular subtypes of breast cancer

目的研究乳腺癌动态增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCEM RI)定量参数与其分子分型的相关性。方法回顾性分析经手术病理证实102例不同分子亚型乳腺癌DCE-M RI定量参数,包括容量转移常数(K^(trans))、速率常数(Kep)和血管外细胞外间隙容积比(V_e)。记录瘤体免疫组织化学的雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体-2(HER-2)及Ki67的表达情况,比较不同分子分型乳腺癌DCE-MRI定量参数的差异,分析生物学预后因子表达与DCE-MRI定参数的相关性。结果不同分子亚型乳腺癌的DCE-MRI定量参数(K^(trans)、Kep、V_e)差异没有统计学意义(H=5.416,P=0.175;H=4.926,P=0.177;H=4.203,P=0.240);ER、PR阴性组的K^(trans)及Kep值高于ER、PR阳性组;HER2阳性组的Kep值高于HER2阴性组(P<0.05),但二组间的K^(trans)值、V_e值及ADC值差异均无统计学意义(P>0.05);Ki67高表达组的K^(trans)、Kep值均高于Ki67低表达组。结论乳腺癌DCE-MRI定量参数不能预测乳腺癌分子亚型,但部分定量参数与预后因子(ER、PR、HER2、Ki67)表达有相关性;K^(trans)、Kep值可以反映乳腺癌的生物学行为,有助于评估乳腺癌预后。

Objective To investigate the association between quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） and molecular subtypes of breast cancers.Methods The DCE-MRI findings were retrospectively analyzed in 102 patients with pathologically confirmed breast cancer.The volume transfer constant （ K trans）, rate constant （ K ep） and volume of EES per unit volume of tissue （ V e） value were calculated.The immunohistochemistry results of estrogen receptor （ER）, progesterone receptor （PR）, human epidermal growth factor receptor-2 （HER-2） and Ki67 were reviewed.The quantitative parameters of DCE-MRI were compared among patients with different immunohistochemical subtype.Results There were no statistically significances in quantitative parameters K trans, K ep and V e among patients with different immunohistochemical subtype（ H =5.416, P =0.175; H =4.926, P =0.177; H =4.203, P =0.240, respectively）. K trans and K ep values were higher in tumors with ER-negative and PR-negative than those with ER-positive and PR-positive. K epvalue was higher in tumors with HER-2-positive than that with HER-2-negative.There was no significant difference in K trans and V e values between HER-2 positive and HER-2 negative tumors （ P 〉0.05）. K trans and K ep values in tumors with high Ki67 expression were higher than those with low Ki67 expression.Conclusion Different subtypes of breast cancer can not be predicted by using DCE-MRI quantitative parameters.However, there is some correlation between DCE-MRI quantitative parameters and the prognostic factors. K trans and K ep values may reflect the biological behavior, which is related to the prognosis of breast cancer.