目的 探讨乳腺癌1.5ＴMRI动态 增强扫描及DWI与免疫组化指标：雌激素 受体(ER)、孕激素受体(PR)、人类表皮生 长因子受体2(CerbB-2)、增值细胞核抗原 (Ki-67)的相关性。方法 选取我院及南通 市第三人民医院2012年1月至2016年12月 收治的乳腺癌患者102例，102例乳腺癌患 者术前行乳腺MRI动态增强扫描及弥散加 权成像序列检查，获得病变的形态学特 征、血流动力学参数及ADC值，在患者术 后检测病理标本，包括组织学分级、淋巴 结情况与免疫组化指标(ER、PR、Ki-67、 CerbB-2)等，分析MRI动态增强扫描形态 学和动力学参数、ADC值与乳腺癌免疫组 化指标间的相关性。结果 (1)102例乳腺 癌患者中，80例患者为浸润性导管癌，以 不规则形患者多见，动态增强扫描肿瘤 不均匀强化者51例，Ⅲ型TIC者69例。患 者平均SER值为(123.54±43.52)%，平均 最大增强斜率值(0.95±0.46)；(2)边缘 状态、最大增强斜率、TIC在各项指标中 相关性均无统计学意义(P>0.05)；肿瘤 形态和肿瘤大小(P<0.001)呈正相关性； ER、PR(P=0.012，P=0.045)与肿瘤形态 呈负相关性；组织学分级(P=0.011)、 ER(P=0.014)、PR（P=0.009)与内部强化 特点呈现负相关性；信号增强率与肿瘤大 小(P=0.016)、淋巴结状态(P<0.001)呈现 负相关性。结论 MRI动态增强及DWI扫描 的形态学和动力学参数与乳腺癌患者免疫 组化间存在一定相关性，可根据肿瘤形 态、内部强化特点及信号增强率对患者预 后进行评估。

Objective To investigate the relationship between DWI and immunohistochemical indexes of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (CerbB-2) Nuclear antigen (Ki67) in lung cancer patients. Methods 102 patients with breast cancer from January 2012 to December 2016 were enrolled in this investigation. 102 cases of patients with breast cancer underwent breast dynamic enhanced MRI scan and diffusion weighted imaging (diffusion weigthed, imaging, DWI) sequence checking, obtain the feature of morphology, hemodynamics and ADC value detection in patients with postoperative pathological specimens, including histological grade, lymph node status and immune group chemical indicators (ER, PR, Ki-67, CerbB, -2), the analysis of dynamic enhanced MRI morphology and kinetics parameters, ADC value of the correlation between the index and breast cancer immunohistochemistry. Results (1) 80 cases of the 102 patients with breast cancer were invasive ductal carcinoma. Patients with irregular form were more common. Dynamic contrast enhanced tumor inhomogeneous enhancement in 51 cases, type III TIC in 69 cases. The mean SER value of patients was (123.54±43.52)%, mean maximum enhancement slope was (0.95±0.46)%. (2) the edge of the state, the maximum enhancement slope, TIC in each index correlation had no statistical significance (P>0.05). Tumor morphology and tumor size (P<0.001) were positively correlated. ER, PR (P=0.012, P=0.045) was negatively correlated with tumor morphology. Histological grading (P=0.011), ER (P=0.014), PR (P=0.009) and internal enhancement showed negative correlation; Signal enhancement rate was negatively correlated with tumor size (P=0.016) and lymph node status (P<0.001). Conclusion The dynamic and dynamic parameters of MRI and DWI scan are correlated with the immunohistochemistry of breast cancer. The prognosis of patients can be evaluated according to tumor morphology, internal enhancement and signal enhancement rate.