基于乳腺磁共振背景实质强化程度与乳腺癌不同分子亚型及临床因素的相关性分析

Correlation analysis of breast MRI-based background parenchymal enhancement with different molecular subtypes and clinical factors of breast cancer

目的 探讨乳腺动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)扫描背景实质强化(background parenchymal enhancement,BPE)程度与乳腺癌不同分子亚型间的相关性。材料与方法 回顾性分析2019~2020年在我院行乳腺磁共振检查患者的临床及影像学资料。选择DCE-MRI注射对比剂后第一期图像评价BPE。采用Spearman相关性检验比较BPE程度与临床各因素间的相关性;采用χ2检验比较BPE程度与乳腺癌不同分子亚型间、绝经与否的差异。结果 入组病例199例,包括Luminal A型32例,Luminal B型118例(其中HER-2阳性48例,HER-2阴性70例),HER-2过表达型24例,基底样型25例。BPE程度与患者年龄、体质量、体质量指数(body mass index,BMI)分层呈负相关(P<0.05);BPE程度与患者身高无显著相关性;BPE程度与患者绝经与否呈正相关(P<0.01),绝经患者BPE以极少或轻度强化为主,未绝经患者BPE以轻、中度强化为主,部分为重度强化,差异具有统计学意义(P<0.01)。BPE程度与乳腺癌分子亚型存在相关性(P<0.05),但组间分析结果显示BPE程度在各分子亚型组间差异无统计学意义(P=0.162);将BPE程度合并后分为极少强化+轻度、中度+重度两组并观察组间差异,结果显示BPE程度在各分子亚型组间差异无统计学意义(P=0.298)。结论 乳腺磁共振BPE程度与患者年龄、体质量、BMI、绝经与否具有相关性,BPE总体与乳腺癌分子亚型存在相关性,但分组后组间差异无统计学意义。

Objective:To explore the correlation between the dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) background parenchymal enhancement(BPE) characteristics and different molecular subtypes of breast cancer.Materials and Methods:Retrospective analysis from 2019 to 2020 clinical and imaging data of patients undergoing breast magnetic resonance examination in our hospital.Select the first phase image evaluation of BPE after the contrast medium injection in DCE-MRI.Use Spearman’s correlation test to compare BPE correlation with various clinical factors;χ2test was used to compare the degree of BPE with different molecular subtypes of breast cancer,the difference between menopause or not.Results:One hundred and ninety-nine cases were enrolled,of which 32 were Luminal A,118 cases of Luminal B [Luminal B(HER-2 positive) 48 cases,Luminal B(HER-2 negative) 70 cases],24 cases of HER-2overexpression type,25 cases of basal-like type.BPE has negative correlation with the patient’s age,weight,and body mass index(BMI)(P<0.05);BPE has no significant correlation with the patient’s height;BPE has a positive correlation with the patient’s menopause(P<0.01),the BPE of menopausal patients is mainly minimal or mildly enhanced,and the BPE of non-menopausal patients is mainly mild or moderate enhancement,some were severe enhancement,and the difference was statistically significant(P<0.01).BPE degree and the molecular subtypes of breast cancer were correlated(P<0.05),but the results of the analysis showed no statistically significant difference among the groups(P=0.162);the combined degree of BPE was divided into minimal+mild,moderate+severe enhancement,the results showed that there was no difference in the degree of BPE among the molecular subtype groups(P=0.298).Conclusions:There has a correlation between BPE with patient’s age,weight,BMI,menopause or not.And the BPE is connected with the molecular subtypes of breast cancer,but there is no difference between the groups after grouping.