MRI定量增强参数与乳腺癌预后因子及分子分型的相关性研究

发布时间：2018-04-14 08:55

本文选题：乳腺肿瘤 + 磁共振成像　；参考：《东南大学》2016年硕士论文

【摘要】：目的探讨MRI定量增强参数与乳腺癌预后因子及分子分型的相关性。方法回顾性分析经手术病理证实为乳腺癌,行乳腺MRI定量动态增强扫描,且术后经免疫组织化学检测的87例患者(91个乳腺癌病灶),其中80例(84个病灶)获得分子分型结果。所有患者均行乳腺MRI平扫及增强扫描,并测量容量转移常数(Ktrans)、速率常数(kep)和血管外细胞外间隙容积比(Ve)。记录免疫组织化学结果,观察雌激素受体(ER)、孕激素受体(PR)和人类表皮生长因子受体-2(Her-2)表达情况,并对患者进行分子分型,同时观察预后因子Ki-67的表达情况。87例患者的91个乳腺癌病灶中,ER阳性病灶68个,阴性病灶18个；PR阳性病灶60个,阴性病灶26个；Her-2阳性病灶30个,阴性病灶58个。确定分子分型的80例(84个病灶)患者中,LuminalA型19个, Luminal B型49个,Her-2阳性型7个,三阴性乳腺癌(TNBC)9个。各受体在不同表达状态下的MRI定量增强参数采用ann-Whitney U检验比较,定量参数和Ki-67表达程度的相关性采用Spearman方法评价,不同分子分型乳腺癌患者的定量参数采用Kniskal-Wallis检验进行组间比较。结果ER、PR阴性患者的Ktrans及kep值高于ER、PR阳性患者,差异有统计学意义(P0.05),Her-2阳性和阴性患者的参数值差异均无统计学意义(P0.05)。Ki-67表达程度的范围为5%-90%,均值为33%,Luminal A, Luminal及Ve值的中位数及四分位间距分别为1.33(0.88)、2.63(2.34)、0.51(0.22)。Ki-67的表达程度与Ktans、kep值及Ve无明显相关性(r值分别为0.24、0.22及0.00,P值分别为0.03、0.04及0.97)。TNBCB型的Ktrans值低于Her-2过表达型及AiminalA型,ILuminal B型及TNBC型的kep值小于TNB型,而Ve值则均高于C , Luminal B型(3.99/min) ,型的kep值低于Her-2过表达型,差异均有统计学意义(P0.05)。TNBC的kep值在各型中最高而Ve值则最小(0.41)。结论通过MRI定量增强参数可一定程度提示乳腺癌预后及不同亚型,与预后相关因子Ki-67无明显相关性。
[Abstract]:Objective to investigate the correlation between quantitative enhancement parameters of MRI and prognostic factors and molecular typing of breast cancer.Methods 87 breast cancer patients (91 breast cancer lesions) confirmed by surgery and pathology were examined by quantitative dynamic contrast enhanced MRI. The results of molecular typing were obtained in 80 patients (84 lesions).All patients underwent plain scan and enhanced scanning of mammary gland, and the volume transfer constant (KT) and extracellular intercellular volume ratio (ECV) were measured.Immunohistochemical results were recorded to observe the expression of estrogen receptor ERA, progesterone receptor PRA and human epidermal growth factor receptor -2 Her-2.Meanwhile, the expression of prognostic factor Ki-67 was observed. Among the 91 breast cancer lesions, 68 were ER positive, 60 were negative, 26 were Her-2 positive and 58 were negative.Among the 80 patients (84 lesions), 19 were Luminal A type, 49 were Luminal B positive Her-2 positive type, and 9 were tri-negative breast cancer patients.The quantitative enhancement parameters of MRI in different expression states were compared by ann-Whitney U test. The correlation between the quantitative parameters and the expression of Ki-67 was evaluated by Spearman method.The quantitative parameters of breast cancer patients with different molecular types were compared by Kniskal-Wallis test.Results the values of Ktrans and kep in ERP PR negative patients were higher than those in ERP PR positive patients.There was no significant difference in parameter values between positive and negative patients with P0.05 or Her-2. The range of expression of Ki-67 was 5-90, and the median and quartile spacing of LumAinal, Luminal and ve values were 1.330.882.632.342.340.51and 0.22ki-67, respectively. The expression of Ki-67 and Ktanskep were measured in the range of 5-90, and the median and quartile distance of the values of Luminal, Luminal and ve were 1.330.882.632.342.340.0.51and 0.22ki-67, respectively.There was no significant correlation between E and E in the Ktrans values of 0.24g 0.22 and 0.0030.04 and 0.97).TNBCB, respectively, which were lower than those of the Her-2 overexpression type, AiminalA type B and TNBC type, respectively, and the kep values of the TNB type were lower than those of the TNB type, and the value of kep of the AiminalA type was lower than that of the TNB type.The value of ve was higher than that of C and Luminal B (3.99% min), and the kep value of type B was lower than that of the type of Her-2 overexpression. The difference was statistically significant (P < 0.05). The value of kep of type B was the highest and the value of ve was the lowest (0.41%).Conclusion the quantitative enhancement parameters of MRI may indicate the prognosis and different subtypes of breast cancer to some extent, and have no significant correlation with the prognostic factor Ki-67.
【学位授予单位】：东南大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R737.9

【参考文献】