摘要
目的:探究基于磁共振动态增强扫描(DCE-MRI)早期强化率与表观弥散系数(ADC)值、背景实质强化(BPE)的多参数模型在乳腺癌分子分型中的诊断价值。方法:选取2024年1—12月于上饶市人民医院确诊的103例乳腺癌患者,根据免疫组化结果将其分为Luminal A型、Luminal B型、HER2阳性、三阴性(TN),比较不同分子分型患者癌灶早期强化率、ADC值及癌灶同侧/对侧BPE的差异;采用ROC曲线评估早期强化率、ADC值、BPE多参数联合模型对乳腺癌分子分型的诊断效能。结果:手术病理证实,103例乳腺癌患者分子分型分布为LuminalA型12例(11.65%)、LuminalB型53例(51.46%)、HER2阳性16例(15.53%)、TN22例(21.36%);TN不均匀强化比例显著低于LuminalA型、Luminal B型,环形强化比例高于Luminal B型、HER2阳性(P<0.05);TN早期强化率均高于其他三型,HER2阳性早期强化率高于Luminal A型、Luminal B型(P<0.05);TN ADC值显著低于其他三型(P<0.05);TN病灶中度至显著强化占比高于Luminal A型、Luminal B型(P<0.05);早期强化率、ADC值、BPE多参数模型对于Luminal A型的AUC为0.835[95%CI(0.753,0.917)](P<0.001),对于Luminal A型+B型的AUC为0.962[95%CI(0.929,0.995)](P<0.001),对于TN的AUC为0.994[95%CI(0.984,1.000)](P<0.001)。结论:基于DCE-MRI早期强化率、ADC值及BPE构建的多参数模型,对于TN具有较高鉴别效能,可为乳腺癌分子分型的无创诊断提供重要影像学参考。
Objective:To explore the diagnostic value of multi-parameter model based on dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)early enhancement rate and apparent diffusion coefficient(ADC)value,background parenchymal enhancement(BPE)on molecular typing of breast cancer.Method:Totally 103 patients with breast cancer diagnosed in Shangrao People's Hospital were selected from January to December 2024.According to the results of immunohistochemistry,they were divided into Luminal A type,Luminal B type,HER2 positive and triple negative(TN)breast cancer.The differences in cancer lesion early enhancement rate,ADC value and cancer lesion ipsilateral/contralateral BPE were compared among different types of patients.ROC curve was used to evaluate the diagnostic efficiency of multi-parameter combined model with early enhancement rate,ADC value and BPE on molecular typing of breast cancer.Result:Surgical pathology confirmed that among the 103 patients with breast cancer,there were 12 cases(11.65%)of Luminal A type,53 cases(51.46%)of Luminal B type,16 cases(15.53%)of HER2 positive,and 22 cases(21.36%)of TN.The proportion of uneven enhancement in TN was significantly lower than that in Luminal A type,Luminal B type,while the proportion of ring enhancement was higher than that in Luminal B type,HER2 positive(P<0.05).The early enhancement rate in TN was higher than that in the other three types,and in HER2 positive type was higher than that in Luminal A type,Luminal B type(P<0.05).The ADC value in TN was significantly lower than that in the other three types(P<0.05).The proportion of cancer lesion ipsilateral moderate to significant enhancement in TN type was higher than that in Luminal A type,Luminal B type(P<0.05).The AUC of multi-parameter model with early enhancement rate,ADC value and BPE for Luminal A type breast cancer was 0.835[95%CI(0.753,0.917)](P<0.001),and the AUC for Luminal A type+B type was 0.962[95%CI(0.929,0.995)](P<0.001),and the AUC for TN was 0.994[95%CI(0.984,1.000)](P<0.001).Conclusion:Multi-parameter model based on DCE-MRI early enhancement rate,ADC value and BPE has high differential efficiency on TN,and can provide important imaging reference for non-invasive diagnosis of breast cancer molecular typing.
作者
王伟明
周鹏
朱正欣
WANG Weiming;ZHOU Peng;ZHU Zhengxin(Imaging Department,Shangrao People's Hospital,Shangrao 334000,China;不详)
出处
《中国医学创新》
2025年第23期144-150,共7页
Medical Innovation of China
基金
上饶市科技计划指导性项目(20242CZDX28)。
关键词
乳腺癌
分子分型
磁共振动态增强扫描
早期强化率
表观弥散系数
Breast cancer
Molecular typing
Dynamic contrast-enhanced magnetic resonance imaging
Early enhancement rate
Apparent dispersion coefficient
