乳腺癌的DCE-MRI、DWI影像特征与其生物标志物表达的相关性研究

Correlation of Imaging Features of DCE-MRI and DWI with Biomarker Expression in Breast Cancer

目的:分析乳腺癌动态增强磁共振成像(DCE-MRI)和扩散加权成像(DWI)的影像特征与乳腺癌相关生物标志物雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)表达的相关性。方法:回顾性分析2017年12月~2019年11月于我院进行DCE-MRI、DWI扫描并经术后病理证实为乳腺浸润性导管癌的94例女性患者资料。术前测定时间-信号强度曲线(TIC)类型和肿瘤平均表观扩散系数(ADC)值,术后采用免疫组化检测ER、PR和HER-2表达情况。比较乳腺癌相关生物标志物与TIC类型、ADC值和形态学等影像特征的相关性。结果:HER-2阳性组的ADC值为(1.015±0.189)×10^-3 mm^2/s,显著高于阴性组的(0.864±0.119)×10^-3 mm^2/s(P<0.05);而ADC值与ER、PR无明显相关性(均P>0.05)。TIC类型、形态学与ER、PR、HER-2均无明显相关性(均P>0.05)。结论:ADC值可用于预测HER-2基因表达情况,为临床选择治疗方案提供参考。

Objective:To analyze the correlation of imaging features of dynamic contrast-enhanced MRI(DCEMRI)and diffusion-weighted imaging(DWI)with the expression of biological markers,such as estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(HER-2)in breast cancer.Methods:A total of 94 patients with invasive ductal carcinoma breast cancer confirmed by pathological detection,who were underwent DWI and DCE-MRI scans in our hospital from December 2017 to November 2019,were enrolled for retrospective analysis.The time-signal intensity curve(TIC)and average apparent diffusion coefficient(ADC)of the tumor were measured preoperation.ER,PR and HER-2 were assessed by immunohistochemical methods postoperation.The correlation of biomarkers mentioned above with TIC type,ADC value and morphological features were analyzed.Results:The ADC value in HER-2 positive patients[(1.015±0.189)×10^-3 mm^2/s]was significantly higher than that of negative group[(0.864±0.119)×10^-3 mm^2/s,P<0.05].However,there was no significant correlation of ADC value with ER and PR(both P>0.05).In addition,neither TIC type nor morphological changes had been correlated with ER,PR and HER-2 with statistical difference(all P>0.05).Conclusion:ADC value can be used to predict expression of HER-2 gene,which would provide reference for treatment option in clinical process.