浸润性乳腺癌MRI弥散加权成像ADC值与分子表达之间的相关性分析

Correlation analysis between ADC value and molecular expression in diffusion-weighted MRI of invasive breast cancer

目的 分析浸润性乳腺癌表观扩散系数(ADC)与雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER-2)、P53表达之间的相关性。方法 收集2016年1月至2021年11月福建省宁德市闽东医院穿刺或手术病理确诊为浸润性乳腺癌患者114例的MRI检查及病理检查资料,分析MRI检查中浸润性乳腺癌形态学改变(边缘毛刺征)、强化特点以及ADC值与ER、PR、HER-2以及P53之间的相关性。结果 浸润性乳腺癌病灶在T1WI、fs T2WI多呈低或等信号,增强扫描早期多表现为由边缘向中心逐渐强化,边缘多有毛刺征。114例乳腺癌病灶DWI均为高信号,ADC图上为低信号,b值越高,病灶ADC值越低,差异有统计学意义(P <0.05)。免疫组化提示ER、PR、HER-2以及P53阳性率分别为80.70%、37.72%、65.79%和47.37%。边缘毛刺征的浸润性乳腺癌患者ER、PR、HER-2以及P53阳性检出率比较,差异无统计学意义(P> 0.05)。增强扫描早期不均匀强化的浸润性乳腺癌患者HER-2阳性检出率高于均匀强化特点者,差异有统计学意义(P <0.05)。b=800及1000 s/mm^(2)时,HER-2阳性检出患者ADC值高于阴性者,b=1000 s/mm^(2)时,P53阳性检出患者ADC值高于阴性检出者,差异有统计学意义(P <0.05)。b=800及1000 s/mm^(2)时,ADC值与HER-2阳性表达之间呈正相关(P <0.05),b=1000 s/mm^(2)时,ADC值与P53表达之间呈正相关(P <0.05)。结论 浸润性乳腺癌患者的ADC值与HER-2及P53蛋白阳性表达之间存在一定的关系,提示从影像角度评估乳腺癌生物学行为及预后具有一定的可行性。

Objective To analyze the correlation between the apparent diffusion coefficient(ADC)and the expression of estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER-2),and P53 in invasive breast cancer.Methods The MRI and pathological examination data of 114 cases of invasive breast cancer diagnosed by puncture or surgical pathology in Mindong Hospital of Ningde City,Fujian Province from January 2016 to November 2021 were collected.The morphological changes(marginal spiculation),enhancement characteristics and the correlation between ADC value and ER,PR,HER-2 and P53 in invasive breast cancer were analyzed.Results Most of the invasive breast cancer lesions showed low or equal signals on T1WI and fs T2WI.In the early phase of enhanced scanning,the lesions were gradually enhanced from the edge to the center,and the edges were often spiculated.In 114 cases of breast cancer,the DWI of the lesions showed a high signal,with a low signal on the ADC map.The higher the b value,the lower the ADC value of the lesion,with a statistically significant difference(P<0.05).The immunohistochemical results showed that the positive rates of ER,PR,HER-2,and P53 were 80.70%,37.72%,65.79%,and 47.37%,respectively.The positive rates of ER,PR,HER-2 and P53 in invasive breast cancer patients with marginal spiculation were compared,without statistically significant differences(P>0.05).The positive rate of HER-2 in invasive breast cancer patients with uneven enhancement at the early stage of enhanced scanning was higher than that in patients with homogeneous enhancement,with a statistically significant difference(P<0.05).When b=800 s/mm2 and 1000 s/mm2,the ADC value of HER-2 positive patients was higher than that of negative patients.When b=1000 s/mm2,the ADC value of P53 positive patients was higher than that of negative patients,with a statistically significant difference(P<0.05).When b=800 s/mm2 and 1000 s/mm2,there was a positive correlation between ADC value and HER-2 positive expression(P<0.05),and when b=1000 s/mm2,there was a positive correlation between ADC value and P53 expression(P<0.05).Conclusion There is a certain relationship between ADC value and HER-2 and P53 protein-positive expression in patients with invasive breast cancer,which suggests that it is feasible to assess the biological behavior and prognosis of breast cancer from the perspective of imaging.