不同分子亚型乳腺癌MRI特征分析

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摘要目的：探讨不同分子亚型乳腺癌的MRI特征。材料与方法：回顾性分析139例病人的术前乳腺MRI图像，包括强化方式、肿块样病灶强化后形态、边缘、内部强化特征、时间-信号强度曲线（TIC）类型、伴随征象。同时记录免疫组化指标ER、PR、HER-2的受体表达情况及Ki-67水平，按照乳腺癌分子亚型分类，分成 Luminal A型、Luminal B型、HER-2阳性型和三阴性乳腺癌（TNBC）。以χ2检验比较各分子亚型间MRI表现的差异，采用交叉列联表方法分析二者的相关性。结果：Luminal A型32例（23.0%），Luminal B型76例（54.7%），HER-2阳性型14例（10.1%），TNBC 17例（12.2%）。肿块样强化病变119例，非肿块样病变20例。肿块样强化病变中，病变的边缘与分子亚型呈低度相关（C=0.360，P=0.008），内部强化特征与分子亚型呈中度相关（Ｃ=0.442，P=0.001），TIC类型与分子亚型呈低度相关（Ｃ=0.318，P=0.019），而病灶的形态及伴随征象与分子亚型无相关性（C=0.065，P=0.791）。结论：不同分子亚型乳腺癌的MRI变现各异，分子亚型与部分MRI征象之间存在一定的相关性，通过术前MRI检查有助于初步判定预后及初步确定治疗方案。

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	孙双燕
	杨长良
	黄志成
	南英姬
	隋长平
	赵继红

关键词 ：乳腺肿瘤, 磁共振成像

Abstract：Objective: To explore the MRI features of different molecular subtypes of breast cancer. Materials and Methods: Pre-operation breast MR images of 139 patients were retrospectively investigated concerning strengthen way, morphological, internal and marginal characteristics of mass like enhancement, time-signal intensity curve types and accompanied signs. Meanwhile, expression levels of immunohistochemistry indices including ER, PR, HER-2 and Ki-67 were recorded, and all subjects were assigned to different groups based on their molecular subtypes: Luminal A, Luminal B, HER-2 positive and TNBC. Differences in MRI characteristics were compared and tested with χ-square test, relevance between MRI characters and molecular subtyping was analyzed by crosstab analysis. Results: N of each group: Luminal A(32), Luminal B(76), HER-2 positive(14), TNBC(17). A total of 119 were mass like enhancement, whereas 20 were non-mass like enhancement. Among the mass like enhancement, the molecular subtype was slight correlated with margin(C=0.360, P=0.008) and time-signal intensity curve type(Ｃ=0.318, P=0.019）, moderately correlated with internal enhancement characteristics(C=0.442, P=0.001), whereas morphology and accompanied signs were not relevant to molecular subtype(C=0.065, P=0.791). Conclusions: Different subtypes of breast cancer showed distinct MRI manifestations, molecular subtyping was partially relevant to MRI characters. Thus, pre- operation MRI is helpful in preliminary determination of prognosis and preliminary preparation of therapeutic plans.

Key words： Breast neoplasms Magnetic resonance imaging

收稿日期: 2016-09-07

PACS:	Ｒ737.9
	Ｒ445.2

基金资助:吉林省科技厅自然科学基金项目（20140101170JC）。

通讯作者: 赵继红，吉林省肿瘤医院放射科，130012。E-mail：jihong1027@aliyun.com

作者简介: 孙双燕（1984-），女，吉林桦甸人，主治医师。E-mail：sunshuangyan007@163.com

引用本文:

孙双燕，杨长良，黄志成，南英姬，隋长平，赵继红. 不同分子亚型乳腺癌MRI特征分析[J]. 中国临床医学影像杂志, 2017, 28(5): 327-330.
SUN Shuang-yan, YANG Chang-liang, HUANG Zhi-cheng, NAN Ying-ji, SUI Chang-ping, ZHAO Ji-hong. MRI features of different molecular subtypes of breast cancer. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(5): 327-330.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2017/V28/I5/327

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