磁共振ADC与乳腺浸润性癌的预后因子表达的相关性研究

Correlation between magnetic resonance apparent diffusion coefficient and expressions of prognostic factors in invasive breast cancer

目的研究磁共振表观扩散系数(apparent diffusion coefficient,ADC)与乳腺浸润性癌的预后因子表达的相关性。方法回顾性分析2019年9月至2022年6月萍乡市人民医院收治的70例乳腺浸润性癌的临床资料,按照病理分期分为早中期乳腺癌组(n=36)与晚期乳腺浸润性癌组(n=34)。比较两组ADC值、肿瘤常规预后因子(肿瘤直径、淋巴结转移状态、病理分级)、生物学预后因子[雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor)PR、人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)、磷蛋白53(phosphoprotein 53,P53)、增殖相关Ki-67抗原(proliferation related Ki-67 antigen,Ki-67)],采用Spearman分析病灶ADC值与生物学预后因子的相关性。结果两组ADC值比较差异无统计学意义;晚期乳腺浸润癌组肿瘤直径大于早中期乳腺浸润癌组,淋巴结转移率、病理分级均高于早中期乳腺浸润癌组,差异有统计学意义(P<0.05)。两组ER、PR、HER2、P53阳性率和Ki-67高表达率比较差异无统计学意义。ER阳性、PR阳性患者的ADC值高于ER阴性、PR阴性患者,差异有统计学意义(P<0.05),HER2阳性、P53阳性、Ki-67阳性患者的ADC值均低于HER2阴性、P53阴性、Ki-67阴性患者,差异有统计学意义(P<0.05);ADC值与ER、PR呈正相关(r>0,P<0.05),与HER2、P53、Ki-67呈负相关(r<0,P<0.05)。结论ADC值与乳腺浸润性癌的预后因子表达有显著相关性,临床可通过检测ADC值制订乳腺癌最佳治疗方案,可为临床乳腺浸润性癌的预后提供参考依据,实现乳腺浸润性癌的精确治疗,改善患者预后。

Objective To study the correlation between magnetic resonance apparent diffusion coefficient(ADC)and expressions of prognostic factors in invasive breast cancer.Methods The clinical data of 70 patients with invasive breast cancer in Pingxiang People's Hospital were retrospectively analyzed from September 2019 to June 2022,they were divided into the early and middle breast cancer group(n=36)and the advanced breast invasive cancer group(n=34).The ADC value,tumor conventional prognostic factors(tumor diameter,lymph node metastasis status,pathological grade),biological prognostic factors(estrogen receptor[ER],progesterone receptor[PR],human epidermal growth factor receptor 2[HER2],phosphoprotein53[P53],proliferation related Ki-67 antigen[Ki-67])were compared between the two groups,Spearman analysis was used to analyze the correlation between ADC value and biological prognostic factors.Results There was no significant difference in ADC values between the two groups;the tumor diameter in the advanced breast invasive cancer group was larger than that in the early and middle breast group,and the lymph node metastasis rate and pathological grade were higher than those in the early and middle breast invasive cancer group,the differences were statistically significant(P<0.05).There was no significant difference in the positive rate of ER,PR,HER2,P53 and the high expression rate of Ki-67 between the two groups.The ADC values of ER positive and PR positive patients were higher than those of ER negative and PR negative patients,and the differences were statistically significant(P<0.05),the ADC values of HER2 positive,P53 positive and Ki-67 positive patients were lower than those of HER2 negative,P53 negative and Ki-67 negative patients,and the differences were statistically significant(P<0.05).ADC value was positively correlated with ER and PR(r>0,P<0.05),and negatively correlated with HER2,P53 and Ki-67(r<0,P<0.05).Conclusion ADC is significantly correlated with the expressions of prognostic factors in invasive breast cancer,the best treatment regimen for breast cancer can be formulated by detecting ADC value in clinical practice,which can provide reference for the prognosis of invasive breast cancer,realize the accurate treatment of invasive breast cancer and improve the prognosis of patients.