乳腺癌患者MRI特征与病理分级、分子分型的关系分析

Analysis of Relationship between MRI Characteristics and Pathological Grading and Molecular Typing in Patients with Breast Cancer

目的探讨乳腺癌患者MRI特征与病理分级、分子分型的关系。方法收集2020年1月至2023年12月我院经病理组织学证实的60例乳腺癌患者病历资料。所有患者均在未接受任何治疗前完成MRI检查,分析MRI特征与病理分级、分子分型的相关性。结果60例患者病理分级Ⅰ级3例(5.00%),Ⅱ级33例(55.00%),Ⅲ级24例(40.00%),Ⅰ级患者肿瘤直径小于Ⅱ级、Ⅲ级(P<0.05),但Ⅱ级、Ⅲ级无统计学差异(P>0.05);Ⅰ级患者强化曲线以流入型为主,占比66.67%,Ⅱ级、Ⅲ级患者以平台型为主,占比75.76%、70.83%,比较存在显著差异(P<0.05)。60例患者分子分型Luminal A型12例(20.00%),Luminal B型37例(61.67%),Her2过表达型4例(6.67%),Triple-Negative型7例(11.67%),Luminal A型、Luminal B型患者边缘均不清晰,而Her2过表达型、Triple-Negative型各有1例边缘清晰患者,比较存在显著差异(P<0.05);Triple-Negative型肿瘤直径最大,Luminal B型最小,比较存在显著差异(P<0.05);Her2过表达型MRI表观扩散系数值最大,Luminal A型最小,比较存在显著差异(P<0.05);Triple-Negative型早期强化率最大,Her2过表达型最小,比较存在显著差异(P<0.05)。结论乳腺癌患者MRI特征与病理分级、分子分型存在一定关系,应重点关注肿瘤大小、病灶边缘、内部强化。

Objective To investigate the relationship between MRI characteristics and pathological grading and molecular typing in patients with breast cancer.Methods The medical records of 60 patients with breast cancer confirmed by histopathology in the hospital were collected from January 2020 to December 2023.All patients completed MRI examination before receiving any treatment,and the correlation of MRI characteristics with pathological grading and molecular typing was analyzed.Results Among the 60 patients,there were 3 cases(5.00%)of pathological grade I,33 cases(55.00%)of gradeⅡand 24 cases(40.00%)of gradeⅢ.The tumor diameter of grade I patients was smaller than that of gradeⅡand gradeⅢ(P<0.05),but there was no statistical difference between gradeⅡand gradeⅢ(P>0.05).The enhancement curve of gradeⅠpatients was dominated by inflow type,accounting for 66.67%,while that of gradeⅡor gradeⅢpatients was dominated by platform type,accounting for 75.76%or 70.83%(P<0.05).The 60 patients were classified into molecular type Luminal A(12 cases,20.00%),Luminal B(37 cases,61.67%),Her2 overexpression type(4 cases,6.67%)and Triple-Negative type(7 cases,11.67%).Luminal A and Luminal B patients had unclear edges,while Her2 overexpression and Triple-Negative patients had 1 patient with clear edge(P<0.05).The tumor diameter of Triple-Negative type was the largest,and that of Luminal B type was the smallest(P<0.05).The MRI apparent diffusion coefficient of Her2 overexpression type was the largest,and that of Luminal A type was the smallest(P<0.05).The early enhancement rate of Triple-Negative type was the highest,and that of Her2 overexpression type was the lowest(P<0.05).Conclusion MRI characteristics of breast cancer patients are related to pathological grading and molecular typing.It is necessary to pay attention to tumor size,lesion edge and internal enhancement.