本文選題：乳腺腫瘤 + 磁共振成像　； 參考：《東南大學(xué)》2016年碩士論文

【摘要】：目的 探討MRI定量增強參數(shù)與乳腺癌預(yù)后因子及分子分型的相關(guān)性。方法回顧性分析經(jīng)手術(shù)病理證實為乳腺癌,行乳腺MRI定量動態(tài)增強掃描,且術(shù)后經(jīng)免疫組織化學(xué)檢測的87例患者(91個乳腺癌病灶),其中80例(84個病灶)獲得分子分型結(jié)果。所有患者均行乳腺MRI平掃及增強掃描,并測量容量轉(zhuǎn)移常數(shù)(Ktrans)、速率常數(shù)(kep)和血管外細(xì)胞外間隙容積比(Ve)。記錄免疫組織化學(xué)結(jié)果,觀察雌激素受體(ER)、孕激素受體(PR)和人類表皮生長因子受體-2(Her-2)表達(dá)情況,并對患者進(jìn)行分子分型,同時觀察預(yù)后因子Ki-67的表達(dá)情況。87例患者的91個乳腺癌病灶中,ER陽性病灶68個,陰性病灶18個；PR陽性病灶60個,陰性病灶26個；Her-2陽性病灶30個,陰性病灶58個。確定分子分型的80例(84個病灶)患者中,LuminalA型19個, Luminal B型49個,Her-2陽性型7個,三陰性乳腺癌(TNBC)9個。各受體在不同表達(dá)狀態(tài)下的MRI定量增強參數(shù)采用ann-Whitney U檢驗比較,定量參數(shù)和Ki-67表達(dá)程度的相關(guān)性采用Spearman方法評價,不同分子分型乳腺癌患者的定量參數(shù)采用Kniskal-Wallis檢驗進(jìn)行組間比較。結(jié)果ER、PR陰性患者的Ktrans及kep值高于ER、PR陽性患者,差異有統(tǒng)計學(xué)意義(P0.05),Her-2陽性和陰性患者的參數(shù)值差異均無統(tǒng)計學(xué)意義(P0.05)。Ki-67表達(dá)程度的范圍為5%-90%,均值為33%,Luminal A, Luminal及Ve值的中位數(shù)及四分位間距分別為1.33(0.88)、2.63(2.34)、0.51(0.22)。Ki-67的表達(dá)程度與Ktans、kep值及Ve無明顯相關(guān)性(r值分別為0.24、0.22及0.00,P值分別為0.03、0.04及0.97)。TNBCB型的Ktrans值低于Her-2過表達(dá)型及AiminalA型,ILuminal B型及TNBC型的kep值小于TNB型,而Ve值則均高于C , Luminal B型(3.99/min) ,型的kep值低于Her-2過表達(dá)型,差異均有統(tǒng)計學(xué)意義(P0.05)。TNBC的kep值在各型中最高而Ve值則最小(0.41)。結(jié)論通過MRI定量增強參數(shù)可一定程度提示乳腺癌預(yù)后及不同亞型,與預(yù)后相關(guān)因子Ki-67無明顯相關(guān)性。
[Abstract]:Objective to investigate the correlation between quantitative enhancement parameters of MRI and prognostic factors and molecular typing of breast cancer.Methods 87 breast cancer patients (91 breast cancer lesions) confirmed by surgery and pathology were examined by quantitative dynamic contrast enhanced MRI. The results of molecular typing were obtained in 80 patients (84 lesions).All patients underwent plain scan and enhanced scanning of mammary gland, and the volume transfer constant (KT) and extracellular intercellular volume ratio (ECV) were measured.Immunohistochemical results were recorded to observe the expression of estrogen receptor ERA, progesterone receptor PRA and human epidermal growth factor receptor -2 Her-2.Meanwhile, the expression of prognostic factor Ki-67 was observed. Among the 91 breast cancer lesions, 68 were ER positive, 60 were negative, 26 were Her-2 positive and 58 were negative.Among the 80 patients (84 lesions), 19 were Luminal A type, 49 were Luminal B positive Her-2 positive type, and 9 were tri-negative breast cancer patients.The quantitative enhancement parameters of MRI in different expression states were compared by ann-Whitney U test. The correlation between the quantitative parameters and the expression of Ki-67 was evaluated by Spearman method.The quantitative parameters of breast cancer patients with different molecular types were compared by Kniskal-Wallis test.Results the values of Ktrans and kep in ERP PR negative patients were higher than those in ERP PR positive patients.There was no significant difference in parameter values between positive and negative patients with P0.05 or Her-2. The range of expression of Ki-67 was 5-90, and the median and quartile spacing of LumAinal, Luminal and ve values were 1.330.882.632.342.340.51and 0.22ki-67, respectively. The expression of Ki-67 and Ktanskep were measured in the range of 5-90, and the median and quartile distance of the values of Luminal, Luminal and ve were 1.330.882.632.342.340.0.51and 0.22ki-67, respectively.There was no significant correlation between E and E in the Ktrans values of 0.24g 0.22 and 0.0030.04 and 0.97).TNBCB, respectively, which were lower than those of the Her-2 overexpression type, AiminalA type B and TNBC type, respectively, and the kep values of the TNB type were lower than those of the TNB type, and the value of kep of the AiminalA type was lower than that of the TNB type.The value of ve was higher than that of C and Luminal B (3.99% min), and the kep value of type B was lower than that of the type of Her-2 overexpression. The difference was statistically significant (P < 0.05). The value of kep of type B was the highest and the value of ve was the lowest (0.41%).Conclusion the quantitative enhancement parameters of MRI may indicate the prognosis and different subtypes of breast cancer to some extent, and have no significant correlation with the prognostic factor Ki-67.
【學(xué)位授予單位】：東南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R737.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 竇瑞雪;楊麗;黃寧;時高峰;;定量DCE-MRI在乳腺良惡性病變診斷中的臨床價值與病理對照研究[J];磁共振成像;2015年08期

2 夏琬君;程敬亮;路彥濤;張焱;;MRI動態(tài)增強7項參數(shù)對乳腺良惡性病灶的診斷價值[J];實用放射學(xué)雜志;2014年12期

3 李二妮;李靜;宋穎;薛梅;周純武;;MRI對乳腺X線攝影檢出的微鈣化病變診斷的價值[J];中華放射學(xué)雜志;2014年12期

4 劉文清;葉京明;徐玲;劉倩;趙建新;段學(xué)寧;劉蔭華;;分子分型及動態(tài)增強磁共振成像對乳腺癌新輔助治療療效的預(yù)測和評價[J];中華外科雜志;2013年08期

5 林奈爾;柴偉明;華佳;;定量動態(tài)增強MRI在乳腺癌中的研究進(jìn)展[J];國際醫(yī)學(xué)放射學(xué)雜志;2013年04期

6 郝亮;余日勝;崔鳳;任興昌;徐海濱;徐坤元;;雌激素受體、孕激素受體和人類上皮因子受體2表達(dá)的乳腺癌亞型的MRI表現(xiàn)特征分析對照研究[J];中華醫(yī)學(xué)雜志;2013年11期

7 梅莉;鄭建剛;王開香;許建興;劉良卿;顧勇堅;周鴻雁;;MRI動態(tài)增強掃描對乳腺纖維腺瘤和乳腺癌的診斷價值[J];實用臨床醫(yī)藥雜志;2013年05期

8 石曉君;張曉佳;王富生;江迦典;林昆;;1991-2010年中國女性乳腺癌的死亡分布特征[J];中華疾病控制雜志;2012年09期

9 張薇薇;許乙凱;;乳腺癌MR動態(tài)增強掃描定量分析及其臨床應(yīng)用[J];國際醫(yī)學(xué)放射學(xué)雜志;2012年03期

10 尹喜;蔣濤;劉小娟;劉錦鋒;李敏;劉東婷;王文川;;動態(tài)增強MRI檢查分級評估良惡性乳腺團(tuán)塊型病灶的價值[J];中華放射學(xué)雜志;2011年12期

，

本文編號：1748568