乳腺癌1.5T MRI动态增强扫描及DWI与免疫组化指标相关性分析

Correlation Analysis of 1.5TMRI Dynamic Contrast-enhanced MR Imaging and DWI and Immunohistochemistry in Breast Cancer

目的探讨乳腺癌1.5TMRI动态增强扫描及DWI与免疫组化指标:雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(Cerb B-2)、增值细胞核抗原(Ki-67)的相关性。方法选取我院及南通市第三人民医院2012年1月至2016年12月收治的乳腺癌患者102例,102例乳腺癌患者术前行乳腺MRI动态增强扫描及弥散加权成像序列检查,获得病变的形态学特征、血流动力学参数及ADC值,在患者术后检测病理标本,包括组织学分级、淋巴结情况与免疫组化指标(ER、PR、Ki-67、Cerb B-2)等,分析MRI动态增强扫描形态学和动力学参数、ADC值与乳腺癌免疫组化指标间的相关性。结果 (1)102例乳腺癌患者中,80例患者为浸润性导管癌,以不规则形患者多见,动态增强扫描肿瘤不均匀强化者51例,Ⅲ型TIC者69例。患者平均SER值为(123.54±43.52)%,平均最大增强斜率值(0.95±0.46);(2)边缘状态、最大增强斜率、TIC在各项指标中相关性均无统计学意义(P>0.05);肿瘤形态和肿瘤大小(P<0.001)呈正相关性;ER、PR(P=0.012,P=0.045)与肿瘤形态呈负相关性;组织学分级(P=0.011)、ER(P=0.014)、PR(P=0.009)与内部强化特点呈现负相关性;信号增强率与肿瘤大小(P=0.016)、淋巴结状态(P<0.001)呈现负相关性。结论 MRI动态增强及DWI扫描的形态学和动力学参数与乳腺癌患者免疫组化间存在一定相关性,可根据肿瘤形态、内部强化特点及信号增强率对患者预后进行评估。

Objective To investigate the relationship between DWI and immunohistochemical indexes of estrogen receptor （ER）, progesterone receptor （PR）, human epidermal growth factor receptor 2 （CerbB-2） Nuclear antigen （Ki- 67） in lung cancer patients.Mctbads 102 patients with breast cancer from January 2012 to December 2016 were enrolled in this investigation. 102 cases of patients with breast cancer underwent breast dynamic enhanced MRI scan and diffusion weighted imaging （diffusion weigthed, imaging, DWI） sequence checking, obtain the feature of morphology, hemodynamics and ADC value detection in patients with postoperative pathological specimens, including histological grade, lymph node status and immune group chemical indicators （ER, PR, Ki-67, CerbB, -2）, the analysis of dynamic enhanced MRI morphology and kinetics parameters, ADC value of the correlation between the index and breast cancer immunohistochemistry. Results （1） 80 cases of the 102 patients with breast cancer were invasive ductal carcinoma. Patients with irregular form were nmre conmmn. Dynanfic contrast enhanced tumor inhomogeneous enhancement in 51 cases, type llI TIC in 69 cases. The mean SElk value of patients was （123.54 ± 43.52）%, mean maximum enhancement slope was （0.95 ± 0.46）%. （2） the edge of the state, the maximunl enhancement slope, TIC in each index correlation had no statistical significance （P〉0.05）. Tumor morphology and tumor size （P〈0.001） were positively correlated. ER, PR （P=0.012, P=0.045） was negatively correlated with tumor morphology. Histological grading （P=0.011）, ER （P=0.014）, PR （P=0.009） and internal enhancement showed negative correlation; Signal enhancement rate was negatively correlated with tumor size （P=0.016） and lymph node status （P〈0.001）. Conclustion The dynanfic and dynamic parameters of MRI and DWI scan are correlated with the immunohistochemistry of breast cancer. The prognosis of patients can be evaluated according to tumor morphology, internal enhancement and signal enhancement rate.