乳腺癌DCE-MRI定量参数与生物学预后因子的相关性研究

摘要

目的：探讨乳腺癌动态增强磁共振成像（DCE-MRI）定量参数与生物学预后因子（ER、PR、HER-2、Ki-67）的相关性。方法对34例乳腺癌患者术前行DCE-MRI检查，测量癌组织的DCE-MRI定量参数（ Ktrans、Kep、Ve）值。术后标本行免疫组织化学染色，测定肿瘤细胞ER、PR、HER-2、Ki-67表达情况。采用Mann-Whitney U秩和检验，比较ER、PR和HER-2不同表达状态时DCE-MRI定量参数的差异。采用Spearman等级相关检验，分析DCE-MRI定量参数与Ki-67表达的相关性。结果 ER、PR不同表达状态时，ER、PR表达阴性组的Kep值均高于阳性组，Kep值的差异均有统计学意义（ P ＜0．05），Ktrans和Ve值的差异均无统计学意义（ P ＞0．05）。 HER-2不同表达状态时，Ktrans、Kep、Ve值的差异均无统计学意义（ P ＞0．05）。 Ktrans值与Ki-67表达呈正相关（ P ＜0．001， r ＝0．731），Kep值与Ki-67表达呈正相关（ P ＝0.019， r ＝0．477），Ve值与Ki-67表达无相关性（ P ＞0．05）。结论乳腺癌DCE-MRI定量参数与生物学预后因子间存在一定的相关性， Ktrans和Kep值可反映乳腺癌的生物学行为，能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。%Objective To study the correlation between DCE-MRI quantitative parameters and biological prognostic factors ( ER, PR, HER-2, Ki-67) in breast cancer.Methods DCE-MRI was performed in 34 cases of breast cancer before operation, and quantitative parameters ( Ktrans , Kep, Ve) were measured.The expression of ER, PR, HER-2 and Ki-67 in postoperative specimens were measured by immunohistochemistry.The correlations between quantitative parameters ( Ktrans , Kep, Ve) and ex-pressions of ER, PR and HER-2 were performed using Mann-Whitney U rank sum test.The correlation between quantitative pa-rameters and expression of Ki-67 was performed using Spearman rank correlation analysis.Results Kep value was higher in breast cancer with ER or PR expression in negative than ER or PR expression in positive, the differences of Kep value were statis-tically significant ( P <0.05).When the expression status of ER or PR was different, the differences of Ktrans, Ve values were not statistically significant ( P >0.05).When the expression status of HER-2 was different, the differences of Ktrans, Kep, Ve values were not statistically significant ( P >0.05).Ktrans value was positively correlated with Ki-67 expression ( P <0.001, r=0.731).Kep value was positively correlated with Ki-67 expression ( P =0.019, r =0.477).Ve value was not correlated with Ki-67 expression ( P >0.05).Conclusion There is some correlation between DCE-MRI quantitative parameters and biological prognostic factors in breast cancer.Ktrans and Kep values can reflect the biologic behavior of breast cancer, which can provide ref-erence for indirectly assessment of prognosis and clinical treatment planning.