乳腺癌MRI征象与ER、Her-2及Ki-67生物学指标的关系

Relationship between MRI signs of breast cancer and biological indicators of ER,Her-2 and Ki-67

目的分析乳腺癌MRI征象与雌激素受体(ER)、人表皮生长因子受体-2(Her-2)及核蛋白抗原(Ki-67)的关系。方法选取2019年4月至2021年7月北京市隆福医院收治的94例乳腺癌患者,收集患者术后癌组织(乳腺癌组)及距瘤体5 cm以上的癌旁组织(癌旁组织组),比较不同组织中ER、Her-2、CerbB-2表达情况,并分析MRI征象与上述指标的相关性。结果乳腺癌组ER、Her-2、CerbB-2阳性表达率显著高于癌旁组织组,差异有统计学意义(P<0.05)。94例患者均为浸润型乳腺癌。MRI检查显示肿瘤直径>2 cm者52例;形态不规则40例;边缘不光整55例,呈毛刺征;分叶征33例;早期环形强化71例;动态曲线分型:Ⅰ型8例,Ⅱ型51例,Ⅲ型35例;内部坏死51例。ER阳性表达者形态不规则、毛刺征、早期环形强化占比明显高于ER阴性表达者,差异有统计学意义(P<0.05)。Her-2阳性表达者形态不规则、内部坏死占比高于Her-2阴性表达者,差异有统计学意义(P<0.05)。Ki-67阳性表达者毛刺征、分叶征占比高于Ki-67阴性表达者,差异有统计学意义(P<0.05)。肿瘤形态、边缘、强化形式与ER阳性表达呈正相关(P<0.05);边缘与Ki-67呈正相关(P<0.05);内部坏死、形态与Her-2阳性表达呈正相关(P<0.05)。结论乳腺癌患者MRI征象与ER、Her-2及Ki-67阳性表达存在一定的相关性,MRI征象与ER、Her-2及Ki-67水平在预测乳腺癌生物学特性中具有一定指导价值。

Objective To analyze the relationship between the breast cancer MRI signs of breast cancer and estrogen receptor(ER),human epidermal growth factor receptor-2(Her-2)and nuclear protein antigen(Ki-67).Methods 94 breast cancer patients admitted to Beijing Longfu Hospital from April 2019 to July 2021 were selected,the postoperative cancer tissues(breast cancer group)and the adjacent tissues(paracancerous tissues group)more than 5 cm from the tumor were collected,compared the expression of ER,Her-2,CerbB-2 in different tissues,and analyzed the correlation between MRI signs and the above indicators.Results The positive expression rate of ER,Her-2,and CerbB-2 in the breast cancer group was significantly higher than that in the adjacent tissue group,and the difference was statistically significant(P<0.05).All 94 patients were invasive breast cancer.MRI examination showed that tumor diameter>2 cm in 52 cases;irregular shape in 40 cases;burr sign in 55 cases,showing burr sign;lobulation sign in 33 cases;early annular enhancement in 71 cases;dynamic curve classification:8 cases of type Ⅰ,51 cases of type Ⅱ,35 cases of type Ⅲ,and 51cases of internal necrosis.The proportions of ER-positive expressors with irregular morphology,burr sign,and early ring enhancement were significantly higher than those with ER-negative expressors,and the difference was statistically significant(P<0.05).Her-2 positive expression was irregular in shape and the proportion of internal necrosis was higher than Her-2 negative expression,the difference was statistically significant(P<0.05).The proportion of spicule sign and lobulation sign in Ki-67 positive expression was higher than that in the negative expression of Ki-67,and the difference was statistically significant(P<0.05).The tumor shape,edge and enhancement form were positively correlated with the positive expression of ER(P<0.05).Margin was positively correlated with Ki-67(P<0.05).The internal necrosis,morphology was positively correlated the positive expression of Her-2(P<0.05).Conclusion There is a certain correlation between the MRI signs of breast cancer patients and the positive expression of ER,Her-2 and Ki-67.MRI signs and ER,Her-2 and Ki-67 levels have certain guiding value in predicting the biological characteristics of breast cancer.