乳腺癌全肿瘤体素内不相干运动-弥散加权成像(IVIM-DWI)直方图定量参数与ER、PR和HER-2表达的相关性

Correlations of whole volume intravoxel incoherent motion-diffusion weighted imaging(IVIM-DWI)histogram quantitative parameters and ER,PR and HER-2 expression in breast cancer

目的探讨乳腺癌全肿瘤体素内不相干运动弥散加权成像(IVIM-DWI)直方图定量参数与乳腺癌雌激素受体(ER)、孕激素受体(PR)和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56例经病理证实的乳腺癌患者(57个病灶)。比较ER、PR和HER-2阳性组与阴性组间真扩散系数(D)、假性扩散系数(D^(*))和灌注分数(f)的直方图参数,包括最小值(minimum)、最大值(maximum)、平均值(mean),第10、25、50、75、90百分位数(10th、25th、50th、75th、90th)及偏度(skewness)及峰度(kurtosis)的差异;分析各直方图参数与乳腺癌ER、PR和HER-2表达的相关性。结果ER阳性组D值的mean、25th、50th、75th均高于ER阴性组;而D值的skewness及kurtosis,D^(*)值的mean、maximum、75th、90th及f值的25th、90th均低于ER阴性组(P均<0.05)。PR阳性组D^(*)值的minimum、10th、25th均高于PR阴性组,而D^(*)值的mean、maximum、75th、90th均低于PR阴性组(P均<0.05)。HER-2阳性组D值的mean、minimum、10th、25th、50th及25th D^(*)值均高于HER-2阴性组(P均<0.05)。D值的mean、25th、50th、75th与ER表达呈弱至中度正相关(r=0.29~0.36,P均<0.05),而D值的kurtosis和skewness、D^(*)值的mean、maximum、75th、90th及25th、90th f值与ER表达呈弱至中度负相关(r=-0.26~-0.41,P均<0.05);D^(*)值的minimum、10th、25th与PR表达呈弱至强度正相关(r=0.27~0.50,P均<0.05),而D^(*)值的mean、maximum、75th与PR表达呈中度至强度负相关(r=-0.31~-0.51,P均<0.05);D值的mean、10th、25th、50th及25th D^(*)值与HER-2表达呈弱至中度正相关(r=0.27~0.38,P均<0.05)。结论IVIM-DWI直方图定量参数与乳腺癌ER、PR和HER-2表达存在不同程度相关性。

Objective To explore the correlations of histogram quantitative parameters of whole volume intravoxel incoherent motion-diffusion weighted imaging(IVIM-DWI)and estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor-2(HER-2)expression in breast cancer.Methods The pathologic and MRI IVIM-DWI data of 56 breast cancer patients(57 lesions)confirmed by pathology were analyzed retrospectively.The histogram parameters of true diffusion coefficient(D value),pseudo diffusion coefficient(D^(*)value)and perfusion fraction(f value)were compared between ER,PR and HER-2 positive and negative groups,including the minimum,maximum,mean,10th,25th,50th(median),75th,90th,skewness and kurtosis.The correlations of the histogram parameters and the expression of ER,PR and HER-2 of breast cancer were analyzed.Results The mean,25th,50th and 75th D values in ER positive group were higher than those in ER negative group,while the skewness and kurtosis of D values,the mean,maximum,75th,90th D^(*)values,25th and 90th f values were lower than those in ER negative group(all P<0.05).The minimum,10th and 25th D^(*)values in PR positive group were higher than those in PR negative group,while the mean,maximum,75th and 90th D^(*)values were lower than those in PR negative group(all P<0.05).The mean,minimum,10th,25th,50th D values and 25th D^(*)value in HER-2 positive group were higher than those in HER-2 negative group(all P<0.05).The mean,25th,50th,75th D values showed weak to moderate positive correlations with ER expression(r=0.29-0.36,all P<0.05),while kurtosis and skewness of D values,the mean,maximum,75th,90th D^(*)values and 25th,90th f values showed weak to moderate negative correlations with ER expression(r=-0.26--0.41,all P<0.05),the minimum,10th,25th D^(*)values showed weak to strong positive correlations with PR expression(r=0.27-0.50,all P<0.05).The mean,maximum,75th D^(*)values showed moderate to strong negative correlations with PR expression(r=-0.31-0.51,all P<0.05),and the mean,10th,25th,50th D values and 25th D^(*)value showed weak to moderate positive correlations with HER-2 expression(r=0.27-0.38,all P<0.05).Conclusion IVIM-DWI histogram quantitative parameters were correlated with the expression of ER,PR and HER-2 in breast cancer in varied degrees.