不同分子亚型乳腺癌患者动态增强MRI定量参数:容量转移(Ktrans)、速率常数(Kep)的变化研究

Changes of Dynamic Contrast-enhanced MRI Quantitative Parameters Volume Transfer (Ktrans) and Rate Constant (Kep) in Patients with Different Molecular Subtypes of Breast Cancer

目的探究不同分子亚型乳腺癌患者动态增强磁共振成像(DCE-MRI)定量参数:容量转移(Ktrans)、速率常数(Kep)的变化。方法回顾性分析136例乳腺癌患者的临床资料及DCE-MRI影像学资料,测量DCE-MRI定量参数(Ktrans、Kep),并记录雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER-2)及Ki67的表达情况,比较不同分子亚型乳腺癌患者Ktrans值、Kep值的差异。结果 TNBC型患者Ktrans值、Kep值显著高于Luminal A型、Luminal B型及HER-2+型,差异有统计学意义(P <0. 05);Luminal A型、Luminal B型、HER-2+型患者Ktrans值、Kep值比较,差异无统计学意义(P> 0. 05)。ER阴性组Ktrans值、Kep值显著高于ER阳性组,PR阴性组Ktrans值、Kep值显著高于PR阳性组,Ki67高表达组Ktrans值、Kep值显著高于Ki67低表达组,差异均有统计学意义(P <0. 05);HER-2阳性组和HER-2阴性组Ktrans值、Kep值比较,差异无统计学意义(P> 0. 05)。结论 DCE-MRI定量参数Ktrans、Kep无法预测乳腺癌患者的分子亚型,但Ktrans、Kep与预后因子(ER、PR、HER-2、Ki67)相关,可反映乳腺癌的生物学行为。

Objective To investigate the changes of dynamic contrast-enhanced magnetic resonance imaging( DCEMRI) quantitative parameters volume transfer( Ktrans) and rate constant( Kep) in patients with different molecular subtypes of breast cancer. Methods The clinical and DCE-MRI imagingdata of 136 patients with breast cancer were retrospectively analyzed. The DCE-MRI quantitative parameters( Ktrans,Kep) were measured,and the expressions of estrogen receptor( ER),progesterone receptor( PR),human epidermal growth factor receptor-2( HER-2) and Ki67 were recorded. The Ktrans and Kep values were compared among patients with different molecular subtypes of breast cancer. Results The Ktrans and Kep values of patients with TNBC were significantly higher than those of patients with Luminal A type,Luminal B type and HER-2+type( P <0. 05),without significant differences among Luminal A type,Luminal B type and HER-2+type( P > 0. 05). The Ktrans value and Kep value were significantly higher in ER negative group than those of ER positive group,significantly higher in PR negative group than those of PR positive group,and significantly higher in Ki67 high expression group than those of Ki67 low expression group( P < 0. 05). There was no significant difference in Ktrans value or Kep value between HER-2 positive group and HER-2 negative group( P > 0. 05). Conclusion DCE-MRI quantitative parameters Ktrans and Kep can not predict the molecular subtypes of breast cancer,but they are related to prognostic factors( ER,PR,HER-2,Ki67),which can reflect the biological behavior of breast cancer.