合成MRI定量参数与乳腺浸润性导管癌分子分型及细胞增殖活性关系研究

Correlation of synthetic MRI quantitative parameters with molecular subtypes and cell proliferation activity in breast invasive ductal carcinoma

目的:探讨合成MRI定量参数与乳腺浸润性导管癌(invasive ductal carcinoma,IDC)不同分子分型及细胞增殖活性的关系。方法:回顾性分析2020年7月至2022年2月于昆明医科大学第三附属医院就诊并经病理证实的112例乳腺IDC患者临床病理资料,均行合成MRI检查,使用ITK-SNAP软件勾画并测量病灶定量参数T1、T2及质子密度(proton density,PD)值。根据雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人类表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)和肿瘤增殖核抗原Ki-67表达情况对病灶进行分组,比较乳腺IDC不同分子分型及细胞增殖活性的合成MRI定量参数差异。结果:112例患者中共有112个乳腺IDC病灶,其中Luminal A型40个、Luminal B型49个、HER-2过表达型8个及三阴性乳腺癌15个。ER阳性/阴性、PR阳性/阴性、HER-2阳性/阴性组之间T1、T2值差异均无统计学意义(均P>0.05),Ki-67高表达组的T1和T2值均高于低表达组(均P<0.05),Luminal A型组的T1、T2值均低于Luminal B型和三阴性乳腺癌组,HER-2过表达型组的T2值低于Luminal B型及三阴性乳腺癌组(均P<0.05)。PD值在不同分子分型及Ki-67表达水平中差异均无统计学意义(均P>0.05)。结论:合成MRI定量参数中T1、T2值对乳腺IDC不同分子分型及细胞增殖活性指标Ki-67鉴别具有一定价值,但PD值价值有限。

Objective:To explore the relationship of synthetic MRI quantitative parameters with molecular subtypes and cell proliferation activity in breast invasive ductal carcinoma.Method:A retrospective analysis was conducted on the clinical and pathological data of 112 patients with breast IDC,who consulted at The Third Affiliated Hospital of Kunming Medical University from July 2020 to February 2022.All patients underwent synthetic MRI,and their T1,T2,and proton density(PD)values were measured using the ITK-SNAP software.Groups of molecular subtypes were confirmed based on the expression of estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER-2),and tumor proliferation antigen Ki-67.The parameters for the different molecular subtypes and Ki-67 expression status of breast IDC were compared.Results:The study included a total of 112 IDC lesions,including 40 Luminal A,49 Luminal B,8 HER-2 overexpression-type,and 15 triple-negative breast cancer lesions.The differences in T1 and T2 values between ER-positive/negative,PR-positive/negative,and HER-2 positive/negative groups were not statistically significant(P>0.05).T1 and T2 values in the Luminal A group were lower than those of the Luminal B and triple-negative groups,while the T2 values in the HER-2 overexpression group were lower than those of the Luminal B and triple-negative groups(P<0.05).There was no significant difference in PD values among the different IDC molecular subtypes(P>0.05).Conclusions:T1 and T2 values of synthetic MRI show potential in distinguishing different molecular subtypes and cell proliferation activity of breast IDC,while the PD value has limited discriminatory value in this regard.