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乳腺癌DCE-MRI影像表现与VEGF、Her-2表达水平的关系研究*

作者:朱辉严 谌力群 许 平 谢 磊

所属单位:广东省农垦中心医院放射科(广东 湛江 524002)

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摘要

目的 分析乳腺癌患者的术前动 态增强磁共振成像(DCE-MRI)特点,探究 其与血管内皮生长因子(VEGF)、人表皮 生长因子受体-2(Her-2)表达水平的关 系。方法 52例乳腺癌患者行术前DCEMRI 扫描,分析其影像学特征,并检测 术后切除肿瘤组织VEGF、Her-2表达情 况,分析其与病灶MRI特点的关系。结 果 乳腺癌MRI特点为边缘多呈毛刺或不 规则状、边界模糊,形态多不规则或分 叶状,部分病灶出现坏死,呈不均匀或 环形强化;大多癌灶T1W1呈略低信号, 抑脂T2W1呈不均匀性高信号,注射对比 剂增强扫描后信号明显均匀或斑驳样不 均匀强化或环形强化;VEGF阳性表达率 80%,Her-2阳性表达率76.67%;VEGF与 乳腺癌MRI边缘毛刺(r=0.451,P=0.013) 和早期边缘强化(r=0.843,P=0.001) 呈显著正相关;Her-2与乳腺癌MRI病 灶内部信号环形强化呈显著正相关 (r=0.451,P=0.034)。结论 乳腺癌DCEMRI影像表现与VEGF、Her-2表达具有一 定相关性,MRI评估乳腺癌治疗和预后具 有一定参考价值。

Objective To analyze the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) findings of patients with breast cancer before operation, and explore the relationship with expression levels of human vascular epidermal growth factor (VEGF) and human epidermal growth factor receptor -2 (Her-2). Methods DCE-MRI scan was performed in 52 patients with breast cancer before operation, and the imaging findings were analyzed. The expression of VEGF and Her-2 was detected, and the relationship with MRI was analyzed. Results MRI findings of breast cancer included edges in burr or irregular shape, fuzzy boundaries, irregular or lobulated shape, some lesions with necrosis, inhomogeneous or circular enhancement; Most of the tumors showed slightly low signal on T1W1, and inhomogeneous high signal on fat suppression T2W1. After injection of contrast agent, the enhanced scan showed obviously homogeneous or mottled inhomogeneous or circular enhancement; The positive expression rate of VEGF was 80%, and the positive expression rate of Her-2 was 76.67%; VEGF was significantly positively correlated with MRI burr (r=0.451, P=0.013) and early edge enhancement (r=0.843, P=0.001) in breast cancer, and Her-2 was significantly positively correlated with MRI internal necrotic lesions (r=0.451, P=0.034). Conclusion There is certain correlation between DCE-MRI findings of breast cancer and the expression of VEGF and Her-2,

【关键词】乳腺癌;DCE-MRI;VEGF; Her-2

【中图分类号】R737.9

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2017.06.023

前言

磁共振动态增强成像(DCE-MRI)为乳腺癌常见影像学检查方法, 敏感度极高,可反映病灶微血管增生情况,进而反映肿瘤病理学情况 [1]。研究显示,MRI影像学特征与癌症相关因子表达具有相关性,但目 前国内相关研究样本不多,癌症相关因子与MRI征象相关各不相同[2]。 本研究探讨血管内皮生长因子(VEGF)、人表皮生长因子受体-2(Her-2) 表达与乳腺癌患者术前DCE-MRI影像学特征关系,旨在为乳腺癌治疗提 供基础研究资料,具体报道如下。