多层螺旋CT诊断不同分子分型乳腺癌肝转移瘤的价值探析

Value of Multi-slice Spiral CT in Diagnosing Liver Metastases of Breast Cancer of Different Molecular Types

目的探析多层螺旋CT(MSCT)诊断不同分子分型乳腺癌肝转移瘤的应用价值。方法2014年2月至2018年12月我院64例确诊的乳腺癌肝转移患者据免疫组化结果分为4种分子类型,即LuminalA型8例、Luminal B型28例、HER-2过表达型16例及TNBC型12例,分析各分型患者肝转移瘤的MSCT影像表现。结果4种分型患者肝转移瘤病灶部位、数目、大小、形状、强化特征与分子分型无关联(P>0.05),但肝转移病灶边界、密度存在显著差异(P<0.05),Luminal B型患者病灶边界模糊占比最高,显著高于Luminal A型、HER-2过表达型、TNBC型患者(P<0.05);Luminal A型、HER-2过表达型患者病灶边界模糊者占比明显高于TNBC型(P<0.05)。Luminal B型、HER-2过表达型患者病灶低密度占比明显低于Luminal A型、TNBC型(P<0.05),等密度占比明显高于Luminal A型、TNBC型(P<0.05)。乳腺癌肝转移病灶边界、密度与分子分型密切相关(P<0.05)。结论MSCT诊断不同分子分型乳腺癌肝转移瘤的应用价值高,可显示肝转移瘤的多方面信息,尤其是不同分子分型患者转移灶边界、密度等存在一定特征,可作为诊断依据,并指导临床治疗。

Objective To investigate the value of multi-slice spiral CT(MSCT) in diagnosing liver metastases of breast cancer of different molecular types. Methods 64 patients with liver metastases of breast cancer confirmed in the hospital from February 2014 to December 2018 were divided into 4 molecular types according to the results of immunohistochemistry, namely 8 cases with Luminal type A, 28 cases with Luminal type B, 16 cases with HER-2 over expression type and 12 cases with TNBC type. The MSCT imaging findings of liver metastases in patients with breast cancer of different types were analyzed. Results There was no correlation between the location, number, size, shape and enhancement characteristics of liver metastases and molecular typing(P>0.05), but there was a significant difference in the boundary and density of liver metastases(P<0.05). The proportion of fuzzy focus boundary in luminal B type was the highest, which was significantly higher than that in luminal a, HER-2 over expression and TNBC type(P<0.05) The proportion of patients with fuzzy focus boundary was significantly higher than that of patients with TNBC(P<0.05). The proportion of low density in luminal B and HER-2 over expression was significantly lower than that in luminal A and TNBC(P<0.05), and the proportion of isodensity was significantly higher than that in luminal A and TNBC(P<0.05). The border and density of liver metastasis in breast cancer were closely related to molecular typing(P<0.05). Conclusion The application value of MSCT in the diagnosis of liver metastases of different molecular types of breast cancer is high. It can display multi-aspect information of liver metastases. The boundaries and density of metastases in patients with different molecular types are characteristic, which can be used as a diagnostic basis to guide clinical treatment.