乳腺癌动态增强MRI表现与分子生物学指标的相关性研究
发布时间：2018-10-31 16:48
【摘要】：目的 分析乳腺癌动态增强MRI表现与分子生物学指标雌激素受体(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 receptor2, Her-2)、核增殖标志物Ki-67表达的相关性。以期通过DCE-MRI表现揭示肿瘤的生物学行为,并为肿瘤的预后评估及临床治疗方案的选择提供影像学参考。从而提高动态增强磁共振检查在临床诊疗中的应用价值。 方法 收集我院2011年04月～2013年08月术前行动态增强磁共振检查,并经手术病理证实的乳腺癌53例共55个肿块,检查前、术前均未行放、化疗治疗。采用德国西门子3.0T超导磁共振扫描仪,常规行T1加权成像(T1weighted imaging, T1WI)、T2加权成像(T2weighted imaging, T2WI)及动态增强扫描,观察病变增强后的形态学特征(肿块大小、形态、边缘)、时间信号强度曲线(time signal-intensity curve, TIC)类型、强化形式、早期增强率等。免疫组化染色测定分子生物学指标ER、PR、Her-2、Ki-67的表达情况。分析乳腺癌动态增强磁共振(dynamic contrast-enhanced magnetic resonance imaging, DCE-MRI)表现与分子生物学指标的相关性。所有数据经SPSS19.0软件处理,采用非参数统计中Spearman等级相关检验,P0.05为差异有统计学意义。 结果 (1)肿块大小与Ki-67阳性表达呈正相关(r=0.279,P0.05),与ER、PR、 Her-2无相关性(r值分别为-0.027、-0.119、0.046,P0.05),肿块越大,其Ki-67阳性表达率越高。 (2)肿块形态与Her-2阳性表达呈正相关(r=0.305,P0.05),与Ki-67阳性表达呈显著正相关(r=0.427,P0.01),与ER、PR无相关性(r值分别为0.102、0.134,P0.05),在类圆形、分叶形及不规则形肿块中,其Her-2、 Ki-67的阳性表达率是依次增高的,肿块倾向于分叶形、不规则形时,其Her-2、Ki-67阳性表达较高。 (3)肿块边缘与ER, PR阳性表达呈正相关(r值分别为0.288,、0.294,P0.05),与Her-2、Ki-67无相关性(r值分别为0.185、0.096,P0.05),即边缘不规则、毛刺的肿块其ER、PR阳性表达率较高。 (4)肿块强化形式与PR阳性表达呈负相关(r=-0.282,P0.05),与ER、Her-2、Ki-67无相关性(r值分别为0.198、-0.211、0.202,P0.05),肿块越倾向于环形强化,其PR阳性表达率越低。 (5)TIC类型与Ki-67阳性表达呈显著正相关(r=0.358,P0.01),与ER、PR、Her-2无相关性(r值分别为0.182、0.067、0.229,P0.05),尤其是倾向于TIC-Ⅲ型时,其Ki-67阳性表达率越高。 (6)早期增强率与Her-2阳性表达呈正相关(r=0.268,P0.05),与ER、PR、Ki-67无相关性(r值分别为0.137、0.223、0.101,P0.05),早期增强率越高,其Her-2阳性表达率越高。 结论 乳腺癌DCE-MRI表现中一些形态学特征(肿块大小、形态、边缘)、强化形式、TIC类型、早期增强率等与分子生物学指标之间存在相关性。乳腺癌DCE-MRI表现可以反映肿瘤的生物学行为,能够间接评估肿瘤预后并为指导临床治疗方案的选择提供参考。
[Abstract]:Objective to analyze the dynamic enhanced MRI and molecular biological index of breast cancer, estrogen receptor (estrogen receptor, ER), progesterone receptor (progesterone receptor, PR), human epidermal growth factor receptor 2 (human epidermal growth factor receptor2, Her-2 (EGF 2 (human epidermal growth factor receptor2, Her-2). Correlation of nuclear proliferation marker Ki-67 expression. The purpose of this study was to reveal the biological behavior of tumor by DCE-MRI and to provide imaging reference for prognosis evaluation and clinical treatment. So as to improve the dynamic enhanced magnetic resonance examination in clinical diagnosis and treatment value. Methods from April 2011 to August 2013, 53 cases of breast cancer were examined with dynamic contrast-enhanced magnetic resonance imaging (Mr). 53 cases of breast cancer proved by operation and pathology were treated with chemotherapy and radiotherapy before examination. Siemens 3.0T superconducting magnetic resonance scanner was used in Germany. T1-weighted imaging (T1weighted imaging, T1WI), T2-weighted imaging (T2weighted imaging, T2WI) and dynamic enhancement were used to observe the morphologic features (size and shape of mass) after enhancement. Edge), time signal intensity curve (time signal-intensity curve, TIC) type, enhancement form, early enhancement rate, etc.). The expression of ER,PR,Her-2,Ki-67 was detected by immunohistochemical staining. To analyze the correlation between dynamic enhanced magnetic resonance (dynamic contrast-enhanced magnetic resonance imaging, DCE-MRI) and molecular biological indexes in breast cancer. All the data were processed by SPSS19.0 software, using non-parametric statistics Spearman grade correlation test, P0.05 for the difference was statistically significant. Results (1) there was a positive correlation between tumor size and Ki-67 positive expression (P 0.05), but no correlation with ER,PR, Her-2 (r = -0.027 ~ -0.119 ~ 0.046). The higher the positive expression rate of Ki-67 was. (2) there was a positive correlation between tumor morphology and Her-2 positive expression (P 0.05), a significant positive correlation with Ki-67 expression (r = 0.427, P0.01), and no correlation with ER,PR (r = 0.102, 0.134, respectively). P0.05), in round, lobular and irregular tumors, the positive expression rate of Her-2, Ki-67 was increased in turn, and the positive expression rate of Her-2,Ki-67 was higher when the mass tended to lobular shape and irregular shape. (3) the positive expression of ER, PR was positively correlated with the margin of the tumor (r = 0.288%, P < 0.05), but not correlated with the expression of Her-2,Ki-67 (r = 0.185%, 0.096%, respectively). The positive expression rate of ER,PR was higher in the tumor of Spurs. (4) the positive expression of PR was negatively correlated with the enhancement of tumor (r = 0.198 ~ 0.211), but not with ER,Her-2,Ki-67 (r = 0.198 ~ (-0.211) ~ (0.202). The more inclined the tumor was to circular enhancement, the lower the positive expression rate of PR was. (5) there was a significant positive correlation between TIC type and Ki-67 positive expression (r = 0.358P 0.01), but no correlation with ER,PR,Her-2 (r = 0.182P 0.067 0. 229P 0.05), especially when TIC- type 鈪，
本文编号：2302928
[Abstract]:Objective to analyze the dynamic enhanced MRI and molecular biological index of breast cancer, estrogen receptor (estrogen receptor, ER), progesterone receptor (progesterone receptor, PR), human epidermal growth factor receptor 2 (human epidermal growth factor receptor2, Her-2 (EGF 2 (human epidermal growth factor receptor2, Her-2). Correlation of nuclear proliferation marker Ki-67 expression. The purpose of this study was to reveal the biological behavior of tumor by DCE-MRI and to provide imaging reference for prognosis evaluation and clinical treatment. So as to improve the dynamic enhanced magnetic resonance examination in clinical diagnosis and treatment value. Methods from April 2011 to August 2013, 53 cases of breast cancer were examined with dynamic contrast-enhanced magnetic resonance imaging (Mr). 53 cases of breast cancer proved by operation and pathology were treated with chemotherapy and radiotherapy before examination. Siemens 3.0T superconducting magnetic resonance scanner was used in Germany. T1-weighted imaging (T1weighted imaging, T1WI), T2-weighted imaging (T2weighted imaging, T2WI) and dynamic enhancement were used to observe the morphologic features (size and shape of mass) after enhancement. Edge), time signal intensity curve (time signal-intensity curve, TIC) type, enhancement form, early enhancement rate, etc.). The expression of ER,PR,Her-2,Ki-67 was detected by immunohistochemical staining. To analyze the correlation between dynamic enhanced magnetic resonance (dynamic contrast-enhanced magnetic resonance imaging, DCE-MRI) and molecular biological indexes in breast cancer. All the data were processed by SPSS19.0 software, using non-parametric statistics Spearman grade correlation test, P0.05 for the difference was statistically significant. Results (1) there was a positive correlation between tumor size and Ki-67 positive expression (P 0.05), but no correlation with ER,PR, Her-2 (r = -0.027 ~ -0.119 ~ 0.046). The higher the positive expression rate of Ki-67 was. (2) there was a positive correlation between tumor morphology and Her-2 positive expression (P 0.05), a significant positive correlation with Ki-67 expression (r = 0.427, P0.01), and no correlation with ER,PR (r = 0.102, 0.134, respectively). P0.05), in round, lobular and irregular tumors, the positive expression rate of Her-2, Ki-67 was increased in turn, and the positive expression rate of Her-2,Ki-67 was higher when the mass tended to lobular shape and irregular shape. (3) the positive expression of ER, PR was positively correlated with the margin of the tumor (r = 0.288%, P < 0.05), but not correlated with the expression of Her-2,Ki-67 (r = 0.185%, 0.096%, respectively). The positive expression rate of ER,PR was higher in the tumor of Spurs. (4) the positive expression of PR was negatively correlated with the enhancement of tumor (r = 0.198 ~ 0.211), but not with ER,Her-2,Ki-67 (r = 0.198 ~ (-0.211) ~ (0.202). The more inclined the tumor was to circular enhancement, the lower the positive expression rate of PR was. (5) there was a significant positive correlation between TIC type and Ki-67 positive expression (r = 0.358P 0.01), but no correlation with ER,PR,Her-2 (r = 0.182P 0.067 0. 229P 0.05), especially when TIC- type 鈪，
本文编号：2302928
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