不同分级乳腺癌BI-RADS MRI特征与血管生成的对比研究

Comparative Study of MRI Features and Angiogenesis of Breast Cancer BI-RADS in Different Grades

目的探讨不同病理分级BI-RADS MRI特征评估乳腺浸润性导管癌(IDC)血管生成的可能性和诊断价值。方法采用免疫组化法检测42例IDC的微血管密度(MVD)并行病理WHO分级,基于ACR BI-RADS标准记录病灶MRI特征:肿瘤内部信号(均质、不均质)、形态(肿块型、非肿块型)及边缘(光整、不光整)。对比分析在不同WHO分级时,IDC的MRI特征与MVD表达差异和相关性。结果不同WHO分级时,IDC的MRI内部信号、边缘特征差异有统计学意义(P<0.05),敏感性均较高(91.7%,85.3%),特异性均较低(38.9%,50.0%)。不同WHO分级时,肿瘤形态特征差异无统计意义(P>0.05)。WHOⅢ级时,IDC信号均匀组的MVD明显高于不均匀组,二者呈正相关(r=0.765,P<0.05);WHOⅠ-Ⅱ级时,边缘不光整组的MVD高于边缘光整组,二者正相关(r=0.570,P<0.05);余WHO分级的MRI特征对应的MVD值差异不明显,且无相关性(P>0.05)。结论 IDC部分BI-RADS MRI特征可在不同病理分级时一定程度上衡量肿瘤血管生成,有一定的诊断价值。

Objective To investigate the diagnostic value and the possibility of angiogenesis in invasive ductal carcinoma of the breast（ IDC） by using MRI features of BI-RADS with different pathological grades.Methods Microvessel density（ MVD）in 42 patients with IDC were detected by immunohistochemical method,and the pathological WHO grading was carried out. MRI features of lesions were recorded based on ACR BI-RADS criteria： tumor internal signals（ homogeneous,heterogeneous）,morphology（ mass type,non-mass type） and edge（ smooth,rough）. The difference and correlation between MRI features and MVD expression of IDC in different WHO grades were compared and analyzed.Results In different WHO grades,there were significant differences in MRI internal signals and marginal features of IDC（ P〈0.05）; the sensitivity was higher（ 91.7%,85.3%） and the specificity was lower（ 38.9%,50.0%）. In different WHO grades,there was no significant difference in morphologic features of tumor（ P〉0.05）.At the WHO III grade,the MVD of the homogeneous IDC signal group was significantly higher than that of the non-uniform group,a positive correlation between them（ r = 0.765,P〈0.05）; At the WHO Ⅰ-Ⅱ grade,the MVD of the group with smooth edge was higher than that of the group with rough edge,a positive correlation between the two groups（ r = 0.570,P〈0.05）; For other WHO grades,there was no significant difference in the MVD values corresponding to the MRI features,and no correlation between them（ P〉0.05）.Conclusion Part of BI-RADS MRI features of IDC can be used to measure tumor angiogenesis in different pathological grades,which has certain diagnostic value.