摘要
目的探讨分析乳腺癌磁共振征象与免疫组化表达水平之间的关系。方法选取我院收治的234例乳腺癌患者病理及MRI资料。根据免疫组化分为雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER-2)阳性或阴性、细胞增殖相关核抗原(Ki-67)高表达或低表达。图像分析由2位不同级别乳腺亚专科医师分别阅片,如有争议,以高职称医师意见为准。动态增强图像及DWI图像经GE-ADW 4.6工作站处理后,由高职称医师判断。共纳入病灶形态、毛刺、ADC值、动态增强早期强化率及曲线类型等5个磁共振参数。定量资料采用t检验或秩和检验,定性资料采用卡方检验,并对有统计学意义的指标进行ROC曲线分析。结果ER、PR阳性患者毛刺出现率高于阴性患者,HER-2阴性患者毛刺出现率高于阳性患者,ER阴性患者中早期强化率中位数高于阳性患者,差异有统计学意义(P<0.05)。Ki-67阳性及阴性患者中5项磁共振参数没有差别。如果以毛刺及早期强化率预测ER、PR、HER-2状态,诊断效能较低。结论乳腺癌免疫组化表达不同,其磁共振成像特征有一定差异,能给临床提供参考意见以及为进一步分析提供基础。
Objective To analyze the correlation between magnetic resonance imaging signs and immunohistochemical expression in breast cancer.methodsA total of 234 patients were included.According to immunohistochemistry,they were divided into the positive or negative expression ofestrogen receptor(ER),progesterone receptor(PR),andhuman epidermal growth factor receptor 2(HER-2),as well as the high or low expressionof cell proliferation associated nuclear antigen(Ki-67).The image analysis is read by two different levels of breast subspecialists,respectively.The senior opinion should prevail.The dynamic enhanced image and DWI image post-processing were processed by GE ADW 4.6 workstation and judged by the senior subspecialists.Five MRI parameters including lesion shape,burr,ADC value,early enhancement rate and curve type were included.T-test or rank sum test was used for quantitative data,chi square test was used for qualitative data,and the statistically significant index ROC curve was analyzed.Results The burr rate of ER and PR positive patients was higher than that of negative patients,the burr rate of HER-2 negative patients was higher than that of positive patients,and the median early enhancement rate of ER negative patients was higher than that of positive patients,with statistically significant(P<0.05).There was no difference in five MRI parameters between Ki-67 positive and negative patients.If the status of ER,PR and HER-2 was predicted by burr and early enhancement rate,the diagnostic efficiency was low.Conclusions The expression of immunohistochemistryin breast cancer is different,and their MRI features are different.It can provide clinical reference and provide a basis for further research.
作者
黄海华
何启强
黄和平
HUANG Haihua;HE Qiqiang;HUANG Heping(Schllo of Public Health Wuhan Unirersity,Chenzhou 423000,China)
出处
《医学影像学杂志》
2023年第6期1020-1023,共4页
Journal of Medical Imaging
基金
湖南省郴州市科学技术局科技发展计划项目(编号:ZDYE2020138)。
关键词
乳腺癌
磁共振成像
ADC值
早期强化率
免疫组化
Breast cancer
Magnetic resonance imaging,ADC value
Early enhancement rate
Immunohistochemistry
作者简介
黄海华(1985-),男,武汉大学公共卫生学院在职硕士研究生,主治医师,主要从事医学影像学诊断工作;通信作者:何启强,E-mail:heqiqiang@gmail.com。
