摘要
目的 总结乳腺癌患者的MRI征象 特点并探析其与免疫组化CerbB-2和Ki-67 表达之间相关性。方法 纳入我院2013年 7月-2015年10月所收治经手术病理证实 的乳腺癌患者62例作为研究对象,均行 MRI检查,用甲醛固定标本并于病理诊断 后进行免疫组织化学染色,记录Ki67与 cerbB-2阳性率。结果 62例乳腺癌患者中 MRI共诊断57例,诊断准确率为91.9%, 4例(6.5%)误诊、1例(1.6%)漏诊。MRI表 现:肿块影57例(46例肿块呈团块状或分 叶状,边界模糊;11例呈小结节状、边界 模糊)。T1WI以等信号、T2WI以高信号为 主。增强扫描病灶多呈不均匀强化。62例 患者中,43例(69.4%)MRI示同侧腋窝淋 巴结信号强度均匀、19例(30.6%)示同侧 腋窝淋巴结信号强度不均匀,提示发生淋 巴结转移,淋巴结形态多不规则、边缘清 楚。结论 乳腺癌患者MRI征象以肿块影、 边界模糊、T1WI等信号、T2WI高信号、增 强扫描呈不均匀强化为主,可作为首选检 查手段,同时在出现以上MRI征象前提下 若发生Ki67或cerbB-2阳性表达,则应警 惕淋巴结转移可能,需积极监测预后。
Objective To summarize the MRI findings of patients with breast cancer and to analyze the correlation between findings and the expression of immunohistochemical CerbB-2 and Ki-67. Methods 62 cases of patients with breast cancer who were confirmed by surgery and pathology in our hospital between July 2013 and October 2015 were included in the study. All performed MRI examination.The specimens were fixed with formalin and after pathological diagnosis, immunohistochemical staining was performed. The positive rates of Ki67 and cerbB-2 were recorded. Results In 62 cases of patients with breast cancer, 57 cases were diagnosed by MRI and the diagnostic accuracy rate was 91.9%. 4 cases (6.5%) were misdiagnosed and 1 case (1.6%) was missed diagnosed. The MRI findings showed that there were mass shadows in 57 cases (46 masses were lumpy or lobulated, with fuzzy boundaries; 11cases were small nodular, with fuzzy boundaries). It showed isointense signal on T1WI and high signal on T2WI. After enhanced scan, lesions showed inhomogeneous enhancement. In 62 patients, MRI findings of 43 cases (69.4%) showed homogeneous ipsilateral axillary lymph node signal strength and 19 cases (30.6%) showed inhomogeneous ipsilateral axillary lymph node signal strength, suggesting there was lymph node metastasis. The shapes of lymph nodes were irregular in shape, with clear edges. Conclusion MRI findings of patients with breast cancer are characterized by mass shadow, fuzzy boundary, isointense signal on T1WI, high signal on T2WI and enhanced scan showinf inhomogeneous enhancement, which can be taken as the preferred examination means. Under the premise of MRI findings mentioned above, there exists positive expression of Ki67 or CerbB-2, doctors should be alert to lymph node metastasis and actively monitor the prognosis.
【关键词】乳腺癌;MRI征象;CerbB-2; Ki-67;免疫组化
【中图分类号】R445.2;R734.4
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.10.021
前言
乳腺癌为多因素、多阶段疾病,与细胞基因表达、新生血管形 成等均有关,对女性身体及心理健康均造成严重危害。有关资料显 示[1],欧美国家乳腺癌发病率正以每年3%幅度升高,我国也同样逐年 升高,目前已居女性恶性肿瘤首位。目前认为自身激素分泌异常、外 界环境及家族遗传等为乳腺癌主要致病因素,但详细发病机制尚不明 确[2]。乳腺癌早期无特异性症状,不少患者确诊时已为中晚期,失去 最佳手术时机会,预后不良,尽早诊断极为重要。X线、超声、MRI等 均为临床常见影像学方法,MRI操作简单、软组织分辨率高、可多方 位成像,成为乳腺癌重要检查手段。此外,乳腺癌患者的免疫组化 CerbB-2和Ki-67表达也逐渐引起重视。本研究为总结乳腺癌患者的MRI 征象特点并探析其与免疫组化CerbB-2和Ki-67表达之间相关性,以我 院收治经手术病理证实的62例乳腺癌患者为例展开分析,现报道如 下。
中国CT和MRI杂志
第15卷, 第 10 期
2017年10月
相关文章