乳腺癌DCE-MRI表现与分子标志物的相关性

目的 分析ER、PR、HER2或Ki-67不同表达状态乳腺癌在DCE-MRI形态学及动态增强特征之间的差异，探讨乳腺癌MRI表现与分子标志物表达状态的相关性。方法 收集经免疫组化检测确定ER、PR、HER2及Ki-67表达状态的乳腺癌病例，均在疗前接受乳腺MRI检查；比较ER、PR、HER2及Ki-67不同表达状态癌灶的MRI形态学征象、动态增强特征的差异。结果 共269例入组。ER阳性癌灶出现小肿块的比例稍高于阴性者，但差异无统计学意义（P=0.055）；ER阴性癌肿边缘光滑的比例稍高于阳性者，但差异亦无统计学意义（P=0.061）。PR阴性癌肿出现边缘光滑的比例高于阳性组（P=0.033）。Ki-67低表达者癌肿出现边缘光滑的比例低于过表达者（P<0.001）。相对于过表达者，HER2低表达及Ki-67低表达者均倾向出现小病灶（P均<0.05）。ER、PR、HER2及不同Ki-67表达状态下癌灶MRI动态增强特征差异无统计学意义。结论 乳腺癌MRI所示癌灶大小和/或边缘状态与ER、PR、HER2及Ki-67表达有一定相关性，动态增强特征与诸分子标记物之间未见稳定相关性。

Correlation of DCE-MRI with molecular markers of breast cancer

Objective To observe morphological and dynamic features on DCE-MRI of ER, PR, HER2 or Ki-67 positive and negative breast cancers, in order to explore the correlation of MRI findings with molecular markers of breast cancer. Methods Totally 269 patients with breast cancers confirmed pathologically underwent breast MRI before treatment, and the ER, PR, HER2 and Ki-67 status were tested. The morphological and dynamic features on DCE-MRI were compared between positive and negative ER, PR, HER2 or Ki-67 tumors. Results The morphological features on MRI of ER positive and negative breast cancers were not significantly different. Compared with negative tumors, ER positive tumors tended to show a small size, but the difference was not statistically significant (P=0.055). More ER negative tumors showed smooth margin than positive ones, but the difference was not statistically significant (P=0.061). PR negative tumors showed smooth margin more often than positive ones (P=0.033). Tumors with low expression status of Ki-67 showed less smooth mass than high expression ones. Tumors in low expression status of HER2 and Ki-67 tended to be of small size compared with those in relative high expression status (all P<0.05). Neither non-mass-like enhancement nor mass-like enhancement showed significant differences of dynamic features on MRI among expression status of ER, PR, HER2 and Ki-67. Conclusion Size and/or margin status on MRI of breast cancers were associated with ER, PR, HER2 and Ki-67 expression status, while no significant relationship of dynamic features with these markers was observed.