期刊文献+
任意字段
题名或关键词
题名
关键词
文摘
作者
第一作者
机构
刊名
分类号
参考文献
作者简介
基金资助
栏目信息

雌激素受体、孕激素受体和人类上皮因子受体2表达的乳腺癌亚型的MRI表现特征分析对照研究 被引量：26

Breast cancer subtypes based on ER/PR and Her2 expression： comparison of mr imaging features
原文传递
导出
摘要 目的探讨基于雌激素受体（ER），孕激素受体（PR）和人类上皮因子受体2（Her2）表达的乳腺癌亚型的MRI特征表现，从影像学角度来预测癌基因的异常表达。方法回顾性分析2007年2月至2011年1月杭州市中医院有完整MR资料，并经病理证实的267例乳腺癌患者的临床、病理和影像学资料。根据BI-RADS的标准，评价MRI表现，包括病灶类型、数目、形态、肿块边缘、肿块信号强度、肿块强化方式及时间-信号增强曲线类型。根据免疫组化中的ER、PR与Her2表达情况将乳腺癌分为4组：（1）ER／PR＋、Her2＋组；（2）ER／PR＋、Her2-组；（3）ER／PR-、Her2＋组；（4）ER／PR-、Her2-组，对比4组之间的差异。分类变量采用，检验和Fisher确切概率法分析。组间两两比较采用矿分割。结果4组乳腺癌亚型病灶类型分布不同，组间差异有统计学意义（χ2=41．267，P〈0．001），其中ER／PR＋、Her2＋组与ER／PR-、Her2＋组中段样或线样强化方式所占比例较高[25．6％（11／43），36．1％（13／36）]，组间差异无统计学意义（χ2=1．112，P=0．641），将两组合并与ER／PR＋、Her2-组及ER／PR-、Her2-组比较，差异有统计学意义（χ2=32．793，P〈0．001；χ2=14．565，P〈0．001）。ER／PR-、Her2-组占总病例数14．6％（39／267），以肿块型为主（92．3％，36／39），多为单发（91．7％，33／36）。与其他组分别比较，ER／PR-、Her2-组肿块边缘多光滑[58．3％（21／36），P〈0．001]；在T2WI压脂像，肿块内部超高信号占33．3％（12／36），肿块周边高信号占30．6％（11／36），均高于其他组，组间差异有统计学意义（P〈0．001）；增强以早期环形强化为主[80．6％（29／36），P〈0．001]。而肿块数目、肿块形态及肿块动态增强模式，组间差异均无统计学意义（χ2=1．413，P=0．713；χ2=8．423，P=0．204；χ2=4．657，P=0．540）。结论段样或线样强化同时结合TIC曲线（呈Ⅱ型或Ⅲ型），有利于预测Her2＋乳腺癌。早期环形强化的肿块为ER／PR-、Her2-乳腺癌最为重要的MRI特征，其余特征包括边缘光滑的乳腺肿块、在T2WI压脂像肿块内部存在超高信号及肿块周边高信号。 Objective To evaluate the magnetic resonance （MR） imaging findings of breast cancer subtypes based on the profiles of ER/PR and Her2. Methods A retrospective study was conducted for 267 breast cancer subjects between February 2007 and January 2011. Clinicopathologic features and MR imaging findings of four subtypes were compared. The Chi-square（χ2） test, Fisher＇s exact test andχ2 section method were employed for categorical variables. Results MR imaging findings：Patients with segment or linear enhancement type accounted for 25.6% in ER/PR＋ , Her2 ＋ subtype group and 36. 1% in ER/PR- , Her2＋ subtype, no significant difference existed between them （χ2 = 1. 112, P = 0.641 ）. But they were significantly higher than ER/PR ＋ , Her2 - subtype group and ER/PR - , Her2 - subtype group （χ2 = 32. 793,P 〈 0. 001 ; ,χ2= 14. 565, P 〈 0. 001 ）. ER/PR- , Her2 - subtype patients accounted for 14. 6% of the total breast cancer patients（ 39/267 ）. Subjects with ER/PR- , Her2- subtype were more likely to present unifocal （91.7%, 33/36）and mass type lesion（92.3%, 36/39）.The mass type lesions in ER/PR-, Her2- subtype group were more likely to showed smooth margin [ 58.3% （ 21/36 ）, P 〈 0. 001 ], very high intratumoral signal and peripheral hyperintense pattern on fat suppression T2-weighted imaging（ P 〈 0. 001 ） and early rim enhancement [ 81.5% （29/36）, P 〈 0. 001 ]. No significantly difference of four subtypes were found on number of mass, mass shape and pattern at dynamic enhancement imaging（χ2 = 1. 413, P = 0. 713 ; χ2 = 8.423, P = 0. 204 ; χ2 = 4. 657, P = 0. 540 ）. Conclusion Segment or linear enhancement type is characterized by MR imaging. Early rim enhanced mass is ER/PR-, Her2-breast cancer. The most important characteristics of MR imaging include a smooth edge of breast mass, very high intratumoral signal on fat suppression T2-weighted imaging and peripheral hyperintense pattern.
作者 郝亮 余日胜 崔凤 任兴昌 徐海滨 徐坤元
机构地区 杭州市中医院放射科 浙江大学医学院附属第二医院放射科
出处 《中华医学杂志》 CAS CSCD 北大核心 2013年第11期819-823,共5页 National Medical Journal of China
关键词 磁共振成像 乳腺肿瘤 受体 雌激素 Magnetic resonance imaging Breast neoplasms Receptors, estrogen
分类号 R737.9 [医药卫生—肿瘤]
  • 相关文献

参考文献11

  • 1Perou CM, Sorlie T, Eisen MB, et al. Molecular portraits ofhuman breast tumours. Nature, 2000, 406 :747-752.
  • 2Wolff AC, Hammond ME, Schwartz JN , et al. American Societyof Clinical Oncology/College of American Pathologists guidelinerecommendationa for human epidermal growth factor receptor 2testing in breast cancer. Arch Pathol Lab Med, 2007, 131 :18-43.
  • 3Onililo AA, Engel JM, Greenlee RT, et al. Breast cancersubtypes based on ER/PR and Her2 expression: comparison ofdinicopathologic features and survival. Clin Med Res, 2GC9, 7:4-13.
  • 4Kobayashi M, Kawashima H,Matsui 0, et al. Two difft*rent typesof ring-like enhancement cm dynamic MR imaging in breastcancer : correlation with the histopathologic findings. J Magn ResonImaging, 2008, 28 : 1435-1443.
  • 5汪晓红,耿道颖,顾雅佳,彭卫军,杨天锡.动态增强MRI鉴别乳腺良恶性病变的价值[J].放射学实践,2005,20(8):662-666. 被引量：58
  • 6Laml) PM, Perry NM, Vinnicombe SJ, et al. Correlation betweenultrasound characteristics, mammographic findings and histologicalgrade in patients with invasive ductal carcinoma of the breast. ClinRadiol, 2000,55:4044.
  • 7Cooke T, Reeves J, Kannigan A , et al. The value of the humanepidermal growth factor receptor-2 ( HER2 ) as a prognosticmarker. Eur J Cancer, 2001,37 Suppl 1 :3-10.
  • 8Mossa-Basha M , Fundaro GM , Shah BA, et a). Ductal carcinomain situ of the breast: MR imaging findings with histopathologiccorrelation. Radiographics, 2010 , 30 : 1673-1687.
  • 9Cleator S, Heller W, Coombes RC. Triple-negative breast cancer:therapeutic options. Lancet Oncol, 2007,8 : 235-244.
  • 10Kang SP, Martel M, Harris LN. Triple negative breast cancer:current understanding of l)iology and treatment options. Curr OpinObstet Gynecol, 2008,20 : 40-46.

二级参考文献13

  • 1Friedrich MC,Sickles EA. Radiological Diagnosis of Breast Diseases[M]. Heidelberg: Springer Verlag, 1997. 261.
  • 2Kuhl CK,Klaschik S,Mielcarek P,et al. DO T2-Weighted Pulse Sequences Help with the Differential Diagnosis of Enhancing Lesions in Dynamic Breast MRI[J]. J Magn Reson Imaging, 1999(9) :187-196.
  • 3Heywang SH,Beck R. Contrst-Enhanced MRI of the Breast[M].Heidelberg : Springer Verlag, 1996.95.
  • 4Nunes LW,Schnall MD,Orel SG,et al. Breast MR Imaging:Interpretation Model[J]. Radiology, 1997,202 (3): 833-841.
  • 5Hulka CA,Edmister WB,Smith BL,et al. Dynamic Echo-Planar Imaging of the Breast :Experience in Diagnosing Breast Carcinoma and Correlationwith Tumor Angiogenesis [J]. Radiology, 1997,205(3): 837-842.
  • 6Kuhl CK,Mielcareck P,Klaschik S,et al. Dynamic Breast MR Imaging: are Signal Intensity Time Course Data Useful for Differential Diagnosis of Enhancing Lsions[J]. Radiology, 1999,211(1): 101-110.
  • 7Malur S,Wurdinger S,Moriz A,et al. Comparison of Written Reports of Mammography, Sonography and Magnetic Resonance Mammography for Preoperative Evaluation of Breast Lesions,with Special Emphasis on Magnetic Resonance Mammography[J]. Breast Cancer Res,2001,3(1) :55-60.
  • 8Rankin SC. MRI of the Breast[J]. Br J Radiol,2000,73(872):806-818.
  • 9Buadu LD,Murakami J,Murayama S,et al. Breast Lesions:Correlation of Contrast Medium Enhancement Patterns on MR Images with Histopathologic Findings and Tumor Angiogenesis[J].Radiology, 1996,200(3): 639-649.
  • 10Liu PF,Debatin JF,Caduff RF,et al. Improved Diagnostic Accuracy in Dynamic Contrast Enhanced MRI of the Breast by Combined Quatitative and Qualitative Analysis[J]. Br J Radiol, 1998,71(845) :501-509.

共引文献57

同被引文献195

  • 1吴氢凯,毛笑园,姜丽,冯洁,罗来敏,惠宁.妊娠晚期雌、孕激素及其受体表达与压力性尿失禁的关系[J].上海交通大学学报（医学版）,2011,31(5):610-614. 被引量：8
  • 2魏丽,段红洁,牛秀珑,刘文星,邓为民.雌激素受体β在乳腺癌他莫昔芬内分泌治疗耐药中的作用[J].中国肿瘤生物治疗杂志,2015,22(1):52-56. 被引量：11
  • 3石毅然,曲建军,李湘洲,马世庆,王峰,王会东,张永庆,王昌亮.MUC1与HER2基因在乳腺癌中的表达及其与临床病理学指标的相关性研究[J].中国肿瘤临床,2007,34(11):621-624. 被引量：7
  • 4La Pensee EW,Ben-Jonathan N.Novel roles of prolactin and estrogens in breast cancer:resistance to chemotherapy[J].Endocr Relat Cancer,2010,17(2):R91-R107.
  • 5Tan DS,Marchi6 C,Jones RL,et al.Triple negative breast cancer:molecular profiling and prognostic impact in adjuvant anthracycline-treated patients[J].Breast Cancer Res Treat,2008,111(1):27-44.
  • 6Mossa-Basha M,Fundaro GM,Shah BA,et al.Ductal carcinoma in situ of the breast:MR imaging findings with histopathologic correlation[J].Radiographics,2010,30(6):1673-1687.
  • 7Chen W, Zheng R, Baade PD, et al. Cancer Statistics in China, 2015[J]. CA CancerJ Clin, 2016,Jan 25. DOl; 10. 33221 caac.21338.
  • 8Glass AG, LaceyJV, CarreonJD, et al. Breast cancer incidence, 1980-2006; combined roles of menopausal hormone therapy, screening mammography, and estrogen receptor status[J].J Natl Cancer Inst,2007 ,99(15) ;1152-1161.
  • 9Hu M, Li P, Li M, et al. Crystal structure of a UBP-family deubiquitinating enzyme in isolation and in complex witb ubiquitin aldehydej L], Cell, 2002,111(7) ;1041-1054.
  • 10Huang X, Summers MK, Pham V, et al. Deubiquitinase USP37 is activated by CDK2 to antagonize APC ( CDH1) and promote S phase entryJ L]. Mol Cell, 2011,42(4);511-523. DOl; 10. 10 161J. molcel. 2011. 03. 027 .

引证文献26

二级引证文献206

中华医学杂志
2013年 第11期

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部