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目的探讨磁共振扩散加权成像表观扩散系数(ADC)与肿块型浸润性乳腺癌5种分子亚型及其生物学预后因子相关性。方法回顾分析64例经手术或活检病理证实为浸润性乳腺癌患者(69个肿块型病灶)的磁共振影像学资料,比较不同分子亚型间平均ADC值及其与乳腺癌生物学预后因子雌激素受体、孕激素受体、人类表皮生长因子受体-2、Ki-67的表达的关系。结果浸润性乳腺癌5种分子亚型间ADC值无显著差异(P>0.05);雌激素受体、孕激素受体、人类表皮生长因子受体-2阳性、阴性组ADC值差异均无统计学意义(P>0.05);但HER2阳性组平均ADC值高于阴性组;Ki-67阳性、阴性组ADC值差异有统计学意义(P=0.023)。阴性组ADC值明显高于阳性组,ADC值与Ki-67的表达呈负相关(r=-0.249)。结论 ADC不能鉴别肿块型浸润性乳腺癌5种分子亚型,但与浸润性乳腺癌预后因子Ki-67的表达存在相关性,对指导治疗和判断预后有一定意义。
Objective To investigate the relationship between apparent diffusion coefficient (ADC) of diffusion-weighted MR imaging and five molecular subtypes of tumor-associated invasive breast cancer and its biological prognostic factors. Methods Magnetic resonance imaging data of 64 patients with invasive breast cancer (69 mass type lesions) confirmed by operation or biopsy were retrospectively analyzed. The average ADC values of different subtypes and their relationship with the biological prognosis factors of breast cancer Hormone receptor, progesterone receptor, human epidermal growth factor receptor-2, Ki-67 expression. Results There was no significant difference in ADC value between 5 subtypes of invasive breast cancer (P> 0.05). There was no statistical difference in ADC values between estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2 positive and negative groups (P> 0.05). However, the mean ADC value of HER2-positive group was higher than that of negative group. The difference of ADC value between Ki-67 positive group and negative group was statistically significant (P = 0.023). Negative group ADC value was significantly higher than the positive group, ADC value and Ki-67 expression was negatively correlated (r = -0.249). Conclusion ADC can not identify five molecular subtypes of tumor type in invasive breast cancer, but it is correlated with the expression of Ki-67, a prognostic factor in invasive breast cancer. It is of great significance to guide therapy and prognosis.