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中华诊断学电子杂志 ›› 2021, Vol. 09 ›› Issue (01) : 40 -45. doi: 10.3877/cma.j.issn.2095-655X.2021.01.010

所属专题: 文献

临床研究

动态增强磁共振半定量参数对乳腺癌人表皮生长因子受体-2表达的预测价值
孟优1, 张帆2, 刘晨鹭2, 沈玉英2, 蔡庆2, 陈双庆2,()   
  1. 1. 215001 南京医科大学附属苏州医院乳腺外科
    2. 215001 南京医科大学附属苏州医院影像科
  • 收稿日期:2020-06-28 出版日期:2021-02-10
  • 通信作者: 陈双庆
  • 基金资助:
    苏州市应用基础研究基金(sys2018083)

The predictive value of semi-quantitative parameters of dynamic contrast enhanced magnetic resonance imaging with human epidermal growth factor receptor 2 in breast cancer

You Meng1, Fan Zhang2, Chenlu Liu2, Yuying Shen2, Qing Cai2, Shuangqing Chen2,()   

  1. 1. Department of Breast Surgery, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215001, China
    2. Department of Radiology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215001, China
  • Received:2020-06-28 Published:2021-02-10
  • Corresponding author: Shuangqing Chen
引用本文:

孟优, 张帆, 刘晨鹭, 沈玉英, 蔡庆, 陈双庆. 动态增强磁共振半定量参数对乳腺癌人表皮生长因子受体-2表达的预测价值[J/OL]. 中华诊断学电子杂志, 2021, 09(01): 40-45.

You Meng, Fan Zhang, Chenlu Liu, Yuying Shen, Qing Cai, Shuangqing Chen. The predictive value of semi-quantitative parameters of dynamic contrast enhanced magnetic resonance imaging with human epidermal growth factor receptor 2 in breast cancer[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2021, 09(01): 40-45.

目的

探讨动态增强磁共振(DCE-MRI)半定量参数对乳腺癌人表皮生长因子受体-2(Her-2)表达的预测价值。

方法

选取2016年1月至2019年12月在南京医科大学附属苏州医院影像科行DCE-MRI检查,并经病理证实的女性浸润性乳腺癌患者,共65例。所有患者病理标本采用免疫组织化学技术检测Her-2的表达,分为Her-2阳性组和Her-2阴性组。两组比较对比剂流入浓度增强率(W-in)、对比剂流出浓度衰减率(W-out)、对比剂浓度达峰时间(TTP)、正向增强积分(PEI)及时间-信号强度曲线(TIC)等半定量参数,并通过受试者工作特征(ROC)曲线分析各参数诊断Her-2阳性的效能。

结果

65例浸润性导管癌患者中,免疫组织化学染色显示Her-2阳性31例,Her-2阴性34例。Her-2阳性组W-in值(1.25±0.19)、TTP值[(0.55±0.10)min]较Her-2阴性组[1.49±0.21,(0.71±0.12)min]明显降低,均差异有统计学意义(t=-4.99,-5.46;均P<0.01);Her-2阳性组W-out值(0.28±0.07)较Her-2阴性组(0.20±0.08)明显升高,差异有统计学意义(t=4.54,P<0.01)。两组间PEI值(145.12±15.81,141.54±17.69)差异无统计学意义(t=0.85,P>0.05);Her-2阳性组和阴性组患者的TIC类型以Ⅱ型(11例,15例)、Ⅲ型(17例,16例)为主,但差异无统计学意义(χ2=0.42,P>0.05)。DCE-MRI半定量参数联合诊断曲线下面积(AUC=0.890)明显高于W-in、W-out、TTP、PEI(AUC=0.813,0.802,0.829,0.589)单个参数,差异有统计学意义(Z=3.39,5.24,3.08,7.34;均P<0.05)。

结论

DCE-MRI半定量参数对判断Her-2阳性乳腺癌具有一定的临床价值,可为治疗方案的选择提供参考依据。

Objective

To investigate the predictive value of semi-quantitative parameters of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) with human epidermal growth factor receptor 2 (Her-2) in breast cancer.

Methods

From January 2016 to December 2019, a total of 65 patients with invasive breast cancer who underwent DCE-MRI in the Imaging Department of Suzhou Hospital Affiliated to Nanjing Medical University and confirmed by pathology were selected. Her-2 expression was detected in all patients by immunohistochemical method, and the patients were divided into Her-2 positive group and Her-2 negative group. Semi-quantitative parameters including rate of contrast enhancement for contrast agent inflow (W-in), rate of contrast decay for contrast agent outflow (W-out), time-to-peak enhancement after contrast agent injection (TTP), positive enhancement integral (PEI) and time-signal intensity curve (TIC) were compared between the two groups. Further, receiver operating characteristic (ROC) curve was used to analyze the effectiveness of each parameter in the diagnosis of positive Her-2.

Results

Among the 65 cases, immunohistochemical staining showed Her-2 positive in 31 cases and Her-2 negative in 34 cases. Compared with Her-2 negative group [1.49±0.21, (0.71±0.12)min], the values of W-in (1.25±0.19) and TTP [(0.55±0.10)min] in the Her-2 positive group were significant decreased (t=-4.99, -5.46, all P<0.01), while the value of W-out (0.28±0.77) in the Her-2 positive group was significant increased compared to Her-2 negative group (0.20±0.08) (t=4.54, P<0.01). However, there was no significant difference in PEI values (145.12±15.81, 141.54±17.69) between the two groups (t=0.85, P>0.05). In addition, TIC types of the two groups were mainly type Ⅱ (11 cases, 15 cases) or Ⅲ (17 cases, 16 cases), and there was no significant difference (χ2=0.42, P>0.05). The area under the curve (AUC) of semi-quantitative parameters combination of DCE-MRI (AUC=0.890) was significant higher than that of single W-in, W-out, TTP, PEI(AUC=0.813, 0.802, 0.829, 0.589) respectively, and the differences of AUC were statistically significant (Z=3.39, 5.24, 3.08, 7.34, all P<0.05).

Conclusion

Semi-quantitative parameters of DCE-MRI have a certain clinical value in the determination of breast cancer with Her-2 positive, and they can provide a reference for clinical treatment.

图1 Her-2阳性右乳浸润性导管癌患者动态增强磁共振检查图像
图2 Her-2阴性左乳浸润性导管癌患者动态增强磁共振检查图像
表1 Her-2阳性组与阴性组乳腺癌患者DCE-MRI半定量参数的比较
图3 DCE-MRI半定量参数诊断Her-2阳性乳腺癌患者ROC曲线分析
表2 DCE-MRI半定量参数单独及联合诊断Her-2阳性乳腺癌的ROC分析
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