不同分子亚型乳腺癌的MRI特征研究

目的探讨不同分子亚型乳腺癌的MRI特征。方法收集2015年3月~2016年12月行3.0 T MRI检查并经病理证实的乳腺癌病例187例,所有病例都能区分不同分子亚型。比较各型乳腺癌在年龄、组织学分类、病理分级、病灶形态、肿块数目、肿块大小、肿块形状、肿块边缘、肿块强化特征、病灶T_2WI信号、TIC曲线、ADC值、瘤周血管上的差异,并采用单因素及多因素分析法进行统计学分析。结果 Luminal A组45例(24.1%),Luminal B组91例(48.7%),HER-2过表达组26例(13.9%),三阴性乳腺癌(TNBC)组25例(13.4%)。TNBC多表现为边缘光整、圆形肿块、环形强化、T_2WI高信号;而TNBC和HER-2过表达型共同表现为具有较高的ADC值、瘤周血供丰富及较高病理分级;Luminal A型则多表现为瘤周血供较少,病理分级较低。结论不同分型乳腺癌特别是TNBC具有一定的MRI特征。

Association between molecular subtypes of breast cancer and MRI findings

Objective To investigate MR findings of different molecular subtypes of breast cancer. Methods From March 2015 to December 2016, 187 patients with 187 breast cancers confirmed by histopathology and examined by 3.0 T MRI were included in the retrospective analysis. MRI findings including tumor size, shape, margin, enhancement pattern, signal intensity on T2-weighted imaging (T2WI), time-intensity curve, apparent diffusion coefficient (ADC) and peritumoral vessels were evaluated. The associations between cancer subtype and patient age, histological types and grades, and MRI findings were assessed using univariate and multivari-ate logistic regression analyses. Results The types of cancer were Luminal A (45), Luminal B (91), HER-2-overexpression (26), and triple negative (25). Higher histological grade was more often detected in triple negative breast cancer (TNBC) and HER-2-overex-pression type. Compared with other subtypes, TNBC more often presented as a round mass with smooth margin, high signal intensity on T2WI and rim enhancement. Higher ADC and increased peritumoral vessels appeared often both in TNBC and HER-2-overexpression type, while less peritumoral vessels was more often found in Luminal A type. Conclusion MRI finding may be helpful in distinguish-ing different molecular subtypes of breast cancer.