磁共振成像MD、ADC和MK参数在浸润性乳腺癌病理分级中的应用及与ER、PR、HER-2、Ki-67的相关性分析

The application of MD,ADC and MK on MRI in the pathological grading of invasive breast cancer and the correlation analysis with ER,PR,HER-2 and Ki-67

目的分析磁共振成像(MRI)平均扩散率(MD)、表观弥散系数(ADC)和扩散峰度平均值(MK)参数在浸润性乳腺癌病理分级中的应用及与雌激素受体(ER)、孕激素受体(PR)、细胞增殖抗原标记物(Ki-67)、人类表皮生长因子受体-2(HER-2)的关系。方法回顾性将65例浸润性乳腺癌患者作为研究对象,均行扩散峰度成像序列的乳腺MR扫描,计算MD、ADC及MK值,采用统计学分析MD、ADC及MK值与浸润性乳腺癌病理分级及与ER、PR、Ki-67、HER-2的关系。结果 MD、ADC及MK值在不同病理分级的浸润性乳腺癌中的比较,均无显著差异(P> 0. 05)。ER阳性患者中MD和ADC值明显低于ER阴性(P <0. 05); MD、ADC值在PR、Ki-67、HER-2(P> 0. 05)不同表达水平中的比较,均无显著差异。MK值在ER、PR、HER-2不同表达水平患者中的比较,均无显著差异(P> 0. 05),但在Ki-67不同表达水平中的比较,Ki-67阳性率> 20%中MK值明显低于Ki-67阳性率≤20%,存在显著差异(P <0. 05)。结论扩散峰度成像序列的乳腺MR扫描对浸润性乳腺癌术前病理分级的评估价值较为有限,但在肿瘤增殖活性具有一定的评估价值,可为后期治疗治疗的选择提供一定的依据。

Objective To analyze the mean diffusivity （MD） , apparent diffusion coefficient （ADC） and mean kurtosis （MK） on magnefie resonance imaging （MRI） in the application of pathological grade of invasive breast cancer and the correlation analysis with estrogen receptor （ER） and progesterone receptor （PR） and antigen identified by monoelonal antibody Ki - 67 （ Ki - 67） , human epidermal growth factor receptor - 2 （HER - 2）. Methods 65 cases of invasive breast cancer were selected as the research objects. The breast MR scan was used to make diffusion kurtosis imaging sequence, and the value of MD, ADC and MK were calculated. The correlation of MD, ADC and MK with pathological grade of invasive breast cancer and ER, PR, Ki - 67, HER - 2 were statistically analyzed. Results There was no significant difference in MD, ADC and MK values in invasive breast cancer with different pathological grades （ P 〉 0.05 ）. Comparison between ER positive and negative patients in MD and ADC, there were significant differences （ P 〈 0.05）. MD and ADC value in PR, Ki - 67, HER - 2 of different expression level showed no significant difference （ P 〉 0.05 ）. There was no significant difference in MK value among patients with different expression levels of ER, PR and HER - 2 （ P 〉 0.05 ） , but tbere was significant difference in Ki - 67 expression levels （ P 〈 0.05 ）. Conclusion Tbe diagnostic value of diffusion kurtosis imaging for breast MR scan is limited in preoperative pathological grading of invasive breast cancer, but it has a certain value in evaluating tumor proliferative activity, and it can provide a basis for later treatment and treatment.