摘要
目的探讨磁共振酰胺质子转移加权(APTw)成像定量参数与乳腺癌p53蛋白表达的相关性,及其对TP53基因突变状态的预测价值。方法回顾性收集2024年3月~2025年9月于广东省第二人民医院经病理证实的72例乳腺癌患者资料。所有患者均接受3T MRI常规序列及APTw扫描。以p53蛋白免疫组化结果为标准,将患者分为TP53突变型组(n=42)与野生型组(n=30)。TP53突变型进一步细分为错义突变亚组(n=32)与无义突变亚组(n=10)。采用CEST-Matlab程序处理APTw图像,在ImageJ软件中手动勾画病灶感兴趣区(ROI),测量APT_(mean)与APT_(max)并比较组间差异,采用Spearman相关分析评估APT参数与p53蛋白表达的相关性,绘制ROC曲线分析诊断效能。结果TP53突变型组的APT_(mean)、APT_(max)均高于野生型组(P<0.001)。APT_(mean)与p53蛋白表达呈中等正相关(r=0.48,P<0.001)。TP53错义与无义突变亚组间APT参数差异无统计学意义(P>0.05)。APT_(mean)诊断TP53突变型的曲线下面积(AUC)为0.838,以截断值2.135%判断时敏感度为92.9%,特异度为66.7%。结论APTw成像定量参数(APT_(mean))与乳腺癌p53蛋白表达呈中等正相关,且对TP53突变型有较高的预测效能,有望为乳腺癌个体化治疗与预后评估提供影像学依据。
Objective To investigate the correlation between quantitative parameters of amide proton transfer-weighted(APTw)magnetic resonance imaging and p53 protein expression in breast cancer,as well as its predictive value for TP53 gene mutation status.Methods Data from 72 patients with pathologically confirmed breast cancer at Guangdong Second Provincial General Hospital between March 2024 and September 2025 were retrospectively collected.All patients underwent 3T MRI including conventional sequences and APTw scanning.Based on immunohistochemical results of p53 protein,patients were divided into the TP53 mutant group(n=42)and wild-type group(n=30).The TP53 mutant group was further subdivided into missense mutation subgroup(n=32)and nonsense mutation subgroup(n=10).APTw images were processed using the CEST-Matlab program.Regions of interest(ROI)of lesions were manually delineated in ImageJ software,and APT_(mean) and APT_(max) were measured and compared between groups.Spearman correlation analysis was performed to evaluate the correlation between APT parameters and p53 protein expression,and receiver operating characteristic(ROC)curves were plotted to analyze diagnostic efficacy.Results APT_(mean) and APT_(max) in the TP53 mutant group were significantly higher than those in the wild-type group(P<0.001).APT_(mean) showed a moderate positive correlation with p53 protein expression(r=0.48,P<0.001).No significant differences in APT parameters were found between the TP53 missense and nonsense mutation subgroups(P>0.05).The area under the ROC curve(AUC)of APT_(mean) in diagnosing TP53 mutation was 0.838,with a sensitivity of 92.9%and specificity of 66.7%at the cutoff value of 2.135%.Conclusion Quantitative APTw parameter(APT_(mean))exhibits a moderate positive correlation with p53 protein expression in breast cancer and has favorable predictive efficacy for TP53 mutation,which is expected to provide an imaging basis for individualized treatment and prognostic evaluation of breast cancer.
作者
冯耀保
韦涛
颜剑豪
Yaobao FENG;Tao WEI;Jianhao YAN(The Second School of Clinical Medicine,Southern Medical University,Guangzhou 510282,China;Department of Imaging,the Second People's Hospital of Guangdong Province,Guangzhou 510403,China)
出处
《分子影像学杂志》
2026年第3期344-352,共9页
Journal of Molecular Imaging
基金
广州市科技计划项目(2023A03J0760)。
