乳腺癌患者新辅助化疗前后的磁共振成像表观扩散系数及其与肿瘤负荷的相关性

The magnetic resonance imaging apparent diffusion coefficient before and after neoadjuvant chemotherapy in patients with breast cancer and its correlation with tumor load

目的:研究乳腺癌患者新辅助化疗前后的磁共振成像表观扩散系数(ADC)及其与肿瘤负荷的相关性。方法:选择我院2015年5月~2018年2月期间拟行乳腺癌根治术的II-III期乳腺癌患者,回顾病史资料并根据是否进行术前新辅助化疗分为接受新辅助化疗的实验组和直接进行手术的对照组。实验组患者新辅助化疗前后进行磁共振成像并测定ADC、对照组患者术前进行磁共振成像并测定ADC;另取两组患者手术切除的肿瘤组织并测定癌基因、侵袭基因的表达量。结果:实验组患者新辅助化疗后的ADC值高于新辅助化疗前且实验组患者新辅助化疗前的ADC值与对照组比较无显著性差异、新辅助化疗后的ADC值与对照组比较显著升高;实验组患者手术切除的肿瘤组织中MCM3、CyclinD1、TC-1、β-catenin、YAP、MMP2的mRNA表达量显著低于对照组,CCN5、ARID1A、PDCD4的mRNA表达量显著高于对照组;高ADC值的肿瘤组织中MCM3、CyclinD1、TC-1、β-catenin、YAP、MMP2的mRNA表达量显著低于低ADC值的肿瘤组织,CCN5、ARID1A、PDCD4的mRNA表达量显著高于低ADC值的肿瘤组织。结论:乳腺癌新辅助化疗后ADC的升高与癌细胞增殖、侵袭的活性相关,能够用于评估化疗前后肿瘤负荷的变化。

Objective： To study the magnetic resonance imaging apparent diffusion coefficient （ADC） before and after neoadjuvant chemotherapy in patients with breast cancer and its correlation with tumor load. Methods： Patients with stage II-III breast cancer who intended to receive radical operation for breast cancer in our hospital between May 2015 and February 2018 were selected and divided into the experimental group who accepted neoadjuvant chemotherapy and the control group who received surgery directly according to the adoption of preoperative neoadjuvant chemotherapy or not in the history data. Experimental group underwent magnetic resonance imaging before and after neoadjuvant chemotherapy to measure the ADC, and control group underwent magnetic resonance imaging before surgery to measure the ADC; the tumor tissues surgically removed from the two groups of patients were collected to measure the expression of oncogenes and invasion genes. Results： ADC value of experimental group after neoadjuvant chemotherapy was higher than that before neoadjuvant chemotherapy, ADC value of experimental group before neoadjuvant chemotherapy was not significantly different from that of control group whereas ADC value after neoadjuvant chemotherapy was significantly higher than that of control group; MCM3, CyclinD1, TC-1, β-catenin, YAP and MMP2 mRNA expression levels in surgically removed tumor tissues of experimental group were significantly lower than those of control group whereas CCN5, ARID1A and PDCD4 mRNA expression levels were significantly higher than those of control group （ P 〈0.05）; MCM3, CyclinD1, TC-1, β-catenin, YAP and MMP2 mRNA expression levels in tumor tissues with high ADC value were significantly lower than those in tumor tissues with low ADC value whereas CCN5, ARID1A and PDCD4 mRNA expression levels were significantly higher than those in tumor tissues with low ADC value （ P 〈0.05）. Conclusion： The increase of ADC after breast cancer neoadjuvant chemotherapy is related to the activity of cancer cell proliferation and invasion, and can be used to evaluate the changes of tumor load before and after chemotherapy.