浸润性乳腺癌动态增强磁共振与分子分型的相关性分析

Study on the correlation between dynamic enhanced magnetic resonance and molecular typing of invasive breast cancer

目的探讨浸润性乳腺癌动态增强磁共振影像特征及其与分子分型的相关性,以指导临床选择合适的治疗方案。方法选取经手术病理证实的57例浸润性乳腺癌患者资料,分析患者的DCE-MRI影像学特征。根据瘤体免疫组织化学的雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体-2(HER-2)及Ki-67的表达情况,将乳腺癌分为Luminal A型、Luminal B型、HER-2过表达型及三阴性四个亚型,比较不同分子亚型乳腺癌的DCE-MRI影像学特征。结果57例患者中Luminal A型占21.1%(12/57),Luminal B型占47.4%(27/57),HER-2过表达型占17.5%(10/57),三阴性乳腺癌占14.0%(8/57);Luminal型乳腺癌MRI检查表现为不规则或分叶状肿块,三阴性乳腺癌边缘较光整且呈环形强化,HER-2过表达型通常为快进快出的强化模式,即Ⅲ型TIC曲线类型。结论不同分子分型的乳腺癌动态增强磁共振的形态学和血流动力学具有相应的特征,可辅助指导临床选择治疗方案并判断预后。

Objective To explore the characteristics of dynamic enhanced magnetic resonance imaging of invasive breast cancer and its correlation with molecular classification,so as to guide clinical selection of appropriate treatment options.Methods We retrospectively collected data of 57 patients with invasive breast cancer confirmed by surgery and pathology,and analyzed the DCE-MRI imaging characteristics of the patients.According to the expression of estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER-2)and Ki-67 in tumor immunohistochemistry,breast cancer was divided into four subtypes,i.e.,Luminal A type,Luminal B type,HER-2 overexpression type,and triple-negative type.The dynamic enhanced MRI imaging characteristics and differences of different molecular subtypes of breast cancer were compared.Results Among 57 cases of breast cancer,Luminal A type accounted for 21.1%(12/57),Luminal B type accounted for 47.4%(27/57),HER-2 overexpression type accounted for 17.5%(10/57),and triple negative breast cancer accounted for 14.0%(8/57).MRI of Luminal breast cancer often presented as irregular or lobulated masses.Triple-negative breast cancers often presented with smooth edges and ring enhancements.HER-2 overexpression was more likely to appear as a fast-in and fast-out enhancement mode,namely type III TIC curve type.Conclusion The morphology and hemodynamics of the dynamic enhanced magnetic resonance of different molecular types of breast cancer have corresponding characteristics,which can assist in guiding the clinical selection of treatment and prognosis judgment.