乳腺癌MRI表现与ER、PR、HER-2表达的相关性研究

目的探讨乳腺癌MRI的表现与ER、PR、HER-2水平之间的关系。方法53例手术病理证实为乳腺癌的患者术前均行乳腺常规MRI、DWI及动态增强扫描。分析乳腺癌的MR特点与各项病理组织学特点及ER、PR、HER-2表达的相关性。采用卡方检验，P〈0．05时认为差异有统计学意义。结果在53例乳腺癌患者中，有毛刺组的ER、PR的阳性表达率低于无毛刺组的ER、PR的阳性率，肿块周围强化较中央明显组的ER、PR的阳性表达率低于强化无差别组的阳性率，腋窝淋巴结转移组的ER、PR的阳性表达率低于腋窝淋巴结无转移组的阳性率；HER-2的阳性表达率与ER、PR相反；经统计学分析有显著性差异（P〈0．05）。结论乳腺癌组织中，ER、PR、HER-2的表达与乳腺癌毛刺征、肿块周围强化程度及淋巴结转移有关，ER、PR、HER-2可以协同判断淋巴结转移、评估预后；乳腺癌的MRI表现有一定的特征，其与乳腺癌各生物学指标密切相关，在一定程度上可为临床治疗方法的选择提供参考。

Correlative study between MRI features and the expression of ER.PR and HER-2 in breast cancer

Objective To investigate the MRI features of breast cancer in correlation with the expressions of ER, PR and HER-2. Methods 53 patients with histologically confirmed breast cancer were enrolled in this study. Conventional MRI, DWI and dynamic contrast-enhanced MRI were performed on all patients before surgery. The relationships among MRI features and expressions of ER,PR and HER-2 were analyzed. Statistical analysis was performed using chi-square test with statistical significance defined as P 〈 0.05. Results The tumors with spiculated margins had lower expression levels of ER and PR than tumors without spiculation （P 〈 0.05）. There were also relative lower expression levels of ER and PR in tumors with peripheral contrast enhancement and axillary lymph node metastasis （P〈 0.05） whereas expression of HER-2 was higher（P 〈 0.05）. Conclusion ER,PR and HER-2 expressions correlate with MRI features of marginal spiculation,peripheral contrast enhancement and lymph-node metastasis of breast cancer. MRI may be useful as a complement to ER, PR and HER-2 expressions for treatment planning and prognosis.