青年女性乳腺癌的MRI及病理特征分析

MRI and Pathological Characteristics of Breast Cancer in Young Women

目的 探讨青年女性乳腺癌的MRI影像特点及病理和免疫组化特征。方法 搜集经病理证实186例女性乳腺癌患者资料,其中青年组84例≤40岁,中老年组102例>40岁。186例患者均行乳腺动态增强MRI(DCE-MRI),其中123例并行DWI检查。对比分析青年组与中老年组MRI影像特征及病理特征、免疫组化的差异。结果 青年组84例患者97个病灶,中老年组102例患者109个病灶,两组在病灶单发、多发无统计学意义。青年组与中老年组在病理组织分级、淋巴结转移及ER、HER2免疫组化检测具有统计学意义(P=0.000、P=0.014、P=0.038、P=0.010),而病理类型、PR、KI-67及分子分型无统计学意义;与中老年组相比,青年组病理组织学分级较高、淋巴结易转移、ER阴性率高、HER-2阳性率高。磁共振结果显示青年组、中老年组均以肿块样强化为主,两组的ADC值无统计学意义。对于肿块样强化病灶两组在MRI最大径、肿块形态、增强信号具有统计学意义(P=0.013、P=0.048、P=0.000);而对于肿块边缘、TIC曲线无统计学意义。青年组病灶较大,同时形态规则、边缘强化的病灶青年组更常见。结论 青年女性乳腺癌的MRI图像、病理及免疫组化与中老年组有一定的差别,青年女性乳腺癌更易表现侵袭性生长、预后差的特点。

Objective To investigate the MRI imaging characteristics, pathological and immunohistochemical characteristics of breast cancer in young women. Methods The data of 186 female breast cancer patients confirmed by pathology were collected, among which 84 were ≤40 years old in the young group and 102 were > 40 years old in the middle and elderly group.Dynamic enhanced breast MRI(DCE-MRI) was performed in all 186 patients, including 123 patients who underwent DWI examination.The differences of MRI image features, clinicopathological features and immunohistochemistry between the young group and the middle-aged group were compared and analyzed. Results There were 97 lesions in 84 patients in the youth group and 109 lesions in 102 patients in the middle and elderly group. There was no statistical significance in single or multiple lesions in the two groups. The pathological tissue grade, lymph node metastasis and IMMUNOhistochemical detection of ER and HER2 were statistically significant(P=0.000, P=0.014, P=0.038, P=0.010) between the young group and the middle and old group, while the pathological type, PR, KI-67 and molecular typing were not statistically significant. Compared with the middle-aged and elderly group, the young group had higher histopathological grade, easy lymph node metastasis, high ER negative rate and high HER-2 positive rate.MRI results showed that mass enhancement was dominant in both the young group and the middle and old group, and the ADC values of the two groups were not statistically significant.The maximum diameter, mass morphology and enhanced signal of MRI were statistically significant(P=0.013, P=0.048, P=0.000) for the two groups of tumor enhancement.There was no statistical significance for the edge of the mass or TIC curve.The lesions in the youth group were larger, and the lesions with regular morphology and enhanced edges were more common in the youth group. Conclusion The MRI images, pathology and immunohistochemistry of breast cancer in young women were different from those in the elderly group, and young women were more likely to show aggressive growth and poor prognosis.