非肿块型强化的乳腺癌磁共振成像表观扩散系数值与HER-2表达的相关性分析

摘要

Objective: To investigate the association of MR apparent diffusion coefficient (ADC) value with HER-2 expression in non-mass-like breast carcinoma. Materials and Methods: Seventy-three cases diagnosed as breast cancers by pathologic examination underwent magnetic resonance prior to surgery. All cases performed non-mass-like enhancement in dynamic contrast-enhanced MR imaging. The expression of HER-2 in tumor tissue were assayed by immunohistochemical (IHC) staining and Fluorescence in situ hybridization (FISH). ADC value was calculated using two b factors (b=0, 800 s/mm2).t test andSpearman rank correlation were used toevaluate correlations between ADC value with HER-2 expression. ROC curve was applied to get the best threshold of ADC value ,which was to judge HER-2 expression.Results:The ADC value in HER-2 positive and negtive expression group was (1.028±0.171)×10-3 mm2/s and (0.931±0.176)×10-3 mm2/s, respectively. The ADC value in the positive expression group was significantly higher (t=2.212, P=0.030). ADC value had positive correlation with the positive expression of HER-2(r=0.294,P=0.012). The best threshold of ADC value to judge HER-2 expression was 0.977×10-3 mm2/s by ROC curve, while the sensitivity and speciifcity were 70.8% and 67.3%, respectively.Conclusions:ADC value may have positive correlation with the expression of HER-2 in non-mass-like breast carcinoma, and draw up the treatment plan and prognosis evaluation for patients.%目的：探讨非肿块型强化的乳腺癌MR扩散加权成像(DWI)表观扩散系数(ADC)值与HER-2表达的相关性。材料与方法搜集经病理证实的乳腺癌73例，术前MRI动态增强均表现为非肿块型强化。行DWI扫描(b=0，800 s/mm2)，测定病灶的ADC 值。应用免疫组织化学(IHC)染色结合荧光原位杂交(FISH)技术测定HER-2的表达情况，应用t检验、Spearmen秩相关分析病灶的ADC值与HER-2表达的相关性，应用ROC曲线分析获得诊断HER-2阳性表达的最佳阈值。结果 HER-2阳性组ADC值为(1.028±0.171)×10-3 mm2/s，阴性组的ADC值为(0.931±0.176)×10-3 mm2/s，且HER-2阳性组ADC值高于阴性组(t=2.212，P=0.030)。ADC值与HER-2阳性表达呈正相关(r=0.294，P=0.012)。ROC曲线分析得到判断HER-2表达的最佳ADC诊断阈值为0.977×10-3 mm2/s，灵敏度和特异度分别为70.8%和67.3%。结论非肿块型强化的乳腺癌的病灶ADC值与HER-2表达呈正相关，可为患者临床治疗方案选择及预后评估提供参考依据。