肿块型与非肿块型乳腺癌MRI弥散加权成像表观扩散系数与分子生物学指标的相关性研究

Study on the correlation between MRI diffusion-weighted imaging apparent diffusion coefficient and molecular biological indexes of mass-like and non-mass-like breast cancer

    摘要
  • 摘要:
    目的 探讨肿块型与非肿块型乳腺癌磁共振弥散加权成像（DWI）表观扩散系数（ADC）与肿瘤分子生物学特征之间的相关性。
    方法 回顾性分析2015年1月至2019年1月珠海市中西医结合医院收治的68例经病理学确诊的乳腺癌患者术前磁共振的DWI资料，患者均为女性，年龄34~72（48.5±4.7）岁；其中肿块型49例，非肿块型19例。采用免疫组化法测定雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）和细胞增殖核抗原Ki-67（简称Ki-67）的表达，肿块型与非肿块型乳腺癌、不同生物学标记物及不同分子亚型乳腺癌的ADC比较采用t检验。采用Spearman等级相关性分析ADC与生物学标志物和分子亚型的相关性。
    结果 肿块型乳腺癌的ADC低于非肿块型（0.95±0.13）×103 mm2/s vs.（1.03±0.12）×103 mm2/s，差异有统计学意义（t=2.193，P=0.023）。19例非肿块型乳腺癌中ER（−）、PR（−）、Ki-67>14%者的ADC低于ER（+）、PR（+）、Ki-67≤14%者（t =2.742、2.054、2.323，均 P<0.05），HER-2过表达型的ADC高于其他分子亚型，且差异均有统计学意义（t=2.515、2.336、2.721，均P<0.05）。49例肿块型乳腺癌中ER（−）、Ki-67>14%者的ADC低于ER（+）、Ki-67≤14%者（t=3.291、2.183，均 P<0.05），HER-2过表达型的ADC高于其他分子亚型，且差异均有统计学意义（t=2.493、2.453、2.512，均P<0.05）。肿块型乳腺癌患者的ADC与ER（+）、PR（+）表达呈正相关，与Ki-67表达水平呈负相关，且差异均有统计学意义（r=0.394、0.360、−0.407，均P<0.05）；非肿块型乳腺癌患者的ADC与ER（+）表达呈正相关，与Ki-67表达水平呈负相关，且差异均有统计学意义（r=0.371、−0.397，均P<0.05）。
    结论 非肿块型乳腺癌的ADC高于肿块型乳腺癌，肿瘤ADC与分子生物学表征具有一定的相关性。

     

    Abstract:
    Objective To investigate the correlation of apparent diffusion coefficient (ADC) value of MRI diffusion-weighted imaging (DWI) in breast cancer of mass-like and non-mass-like breast cancer with tumor molecular biomarkers.
    Methods DWI of 68 breast cancer patients admitted to Zhuhai Integrative Medicine Hospital from January 2015 to January 2019 before operation was retrospectively analyzed, all patients were female, aged 34−72 (48.5±4.7) years, 49 case mass-like and 19 case non-mass-like breast cancer patients . Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2) and cancer antigen were expressed by immunohistochemical assay, and the molecular subtypes were evaluated. T-test was used to compared the ADC of tumor type and non-tumor type breast cancer, different biological markers and different molecular subtypes of breast cancer. The correlation between ADC values and molecular markers and subtypes was analyzed by Spearman level correlation.
    Results The ADC value of mass-like breast cancer was significantly lower than that of non-mass-like breast cancer ((0.95±0.13)×103 mm2/s vs. (1.03±0.12)×103 mm2/s, t=2.193, P=0.023). The ADC values of 19 non-mass-like breast cancer patients with ER(−), PR(−) and Ki-67>14% were significantly lower than those of ER(+), PR(+) and Ki-67≤14% (t=2.742, 2.054, 2.323; all P<0.05), and patients with the HER-2 overexpression type was higher than other molecular subtypes (t=2.515, 2.336, 2.721; all P<0.05). The ADC values of 49 mass-like breast cancer patients with ER(−) and Ki-67>14% were significantly lower than those of ER(+) and Ki-67≤14% (t=3.291, 2.183; both P<0.05) and patients with the HER-2 overexpression type was higher than other molecular subtypes(t=2.493, 2.453, 2.512; all P<0.05). The ADC value of mass-like breast cancer was positively correlated with the negative expression of ER (+) and PR (+), and the expression level of Ki-67 (r=0.394, 0.360, −0.407; all P<0.05). The ADC value of mass-like breast cancer was positively correlated with ER (+) negative expression and Ki-67 expression (r=0.371, −0.397; both P<0.05).
    Conclusion The ADC value of non-mass-like breast cancer is higher than that of mass-like, and the ADC value has a good correlation with the expression of molecular biological characterization.

     

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