乳腺癌患者DCE-MRI各参数与MVD、VEGF的关系及其临床诊断价值
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摘要
目的:探讨DCE-MRI各参数与MVD、VEGF的关系及其临床诊断价值。方法:选取2016年3月至2017年3月间我院收治的112例乳腺疾病患者依照病理检查结果分为良性病变组及恶性病变组;使用磁共振对患者进行检查,使用Neuro-3D软件测定ADC值,使用Mean-Curve软件绘制TIC曲线,通过MIP图计算NTV,绘制TIC曲线行分型处理,并测算Slope、EER、Tpeak、SImax参数;采用免疫组化分析各病灶组织MVD、VEGF;后分析DCE-MRI各参数与MVD、VEGF的关系及其临床诊断价值。结果:NTV≥2条作为评判标准,良性病变组中病灶10.26%,恶性病变组病灶占68.00%;恶性病变组患者病灶TIC为流出型及平台型,良性病变区为平台型及单相型;恶性病变组及良性病变组患者BI-RADS评分差异存在统计学意义(P<0.05);MVD与DCE-MRI的EER、TIC类、Tpeak、NTV及ADC值显著正相关(P<0.05),VEGF与DCE-MRI的TIC类型、Tpeak、NTV及ADC值显著正相关(P<0.05);恶性病变组患者病灶组mMVD、cMVD及VEGF均显著高于良性病变组(P<0.05);恶性病变组患者EER、NTV、Slope显著高于良性病变组(P<0.05),且恶性病变组患者SImax、Tpeak及ADC显著低于良性病变组(P<0.05)。结论:MVD、VEGF与DCE-MRI的NTV、TIC类型、ADC及Tpeak存一定相关关系,上述参数可反映恶性、良性病变的血管差异,其可评估乳腺病变的生物学性质及预后治疗,影响较小。
Purpose: To investigate the relationship between DCE-MRI parameters and MVD, VEGF of breast cancer and its clinical diagnostic value. Methods: One hundred and twelve cases of breast disease were selected from March 2016 to March 2017 in our hospital. According to the results of pathological examination, these cases were divided into benign group and malignant group. All the patients were undergone magnetic resonance imaging,ADC value was determined by using Neuro-3 D software, TIC curve was obtained by Mean-Curve software, NTV was calculated by MIP. The type of TIC curve was classified, and parameters of Slope, EER, Tpeak, SImax were calculated. The tumor tissue MVD and VEGF were analyzed by immunohistochemical exam. The relationships between DCE-MRI parameters and MVD, VEGF and clinical diagnosis were also analyzed. Results: Take NTV more than or equal to 2 as the evaluation standard, 10.26% lesions were in the benign group, 68% lesions were in the malignant group; malignant lesions were with outflow type and platform type TIC, benign lesions were with theplatform type and single phase type; The differences of BI-RADS score in malignant lesions and benign lesions were with statistical significance(P<0.05); there was positive correlation between MVD and DCE-MRI parameters of EER, TIC, Tpeak, NTV and ADC values(P<0.05), and also between VEGF and DCE-MRI parameters of TIC, Tpeak, NTV and ADC values(P<0.05); cMVD, mMVD and VEGF in patients with malignant lesions were significantly higher than those in benign group(P<0.05); EER, NTV and Slope in malignant group were significantly higher than those in benign group(P<0.05), and SImax, Tpeak and ADC in malignant group were significantly lower than those in benign group(P<0.05). Conclusions: There were correlations between MVD, VEGF and DCE-MRI parameters of NTV, TIC, Tpeak and ADC. These parameters can reflect differences in malignant and benign lesions of blood vessels, which can be used to evaluate the biological characteristics and prognosis of treatment in breast lesions.
Purpose: To investigate the relationship between DCE-MRI parameters and MVD, VEGF of breast cancer and its clinical diagnostic value. Methods: One hundred and twelve cases of breast disease were selected from March 2016 to March 2017 in our hospital. According to the results of pathological examination, these cases were divided into benign group and malignant group. All the patients were undergone magnetic resonance imaging,ADC value was determined by using Neuro-3 D software, TIC curve was obtained by Mean-Curve software, NTV was calculated by MIP. The type of TIC curve was classified, and parameters of Slope, EER, Tpeak, SImax were calculated. The tumor tissue MVD and VEGF were analyzed by immunohistochemical exam. The relationships between DCE-MRI parameters and MVD, VEGF and clinical diagnosis were also analyzed. Results: Take NTV more than or equal to 2 as the evaluation standard, 10.26% lesions were in the benign group, 68% lesions were in the malignant group; malignant lesions were with outflow type and platform type TIC, benign lesions were with theplatform type and single phase type; The differences of BI-RADS score in malignant lesions and benign lesions were with statistical significance(P<0.05); there was positive correlation between MVD and DCE-MRI parameters of EER, TIC, Tpeak, NTV and ADC values(P<0.05), and also between VEGF and DCE-MRI parameters of TIC, Tpeak, NTV and ADC values(P<0.05); cMVD, mMVD and VEGF in patients with malignant lesions were significantly higher than those in benign group(P<0.05); EER, NTV and Slope in malignant group were significantly higher than those in benign group(P<0.05), and SImax, Tpeak and ADC in malignant group were significantly lower than those in benign group(P<0.05). Conclusions: There were correlations between MVD, VEGF and DCE-MRI parameters of NTV, TIC, Tpeak and ADC. These parameters can reflect differences in malignant and benign lesions of blood vessels, which can be used to evaluate the biological characteristics and prognosis of treatment in breast lesions.
引文
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[9]刘平贤,门琤,郭满.乳腺癌患者血清VEGF、PRL、HER2、TPS、sC D40L及MVD与复发转移的相关性研究.中国妇幼保健,2015,30:1377-1379.
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[11]Yin J,Yang J,Lu H,et al.Quantitative discrimination between invasive ductal carcinomas and benign lesions based on semi-automatic analysis of time intensity curves from breast dynamic contrast enhanced MRI.Journal of Experimental&Clinical Cancer Research,2015,34:1-10.
[12]Petrillo A,Fusco R,Petrillo M,et al.Standardized Index of Shape(SIS):a quantitative DCE-MRI parameter to discriminate responders by nonresponders after neoadjuvant therapy in LARC.European Radiology,2015,25:1935.
[13]段筱娟,李志义,杨玉涛,等.乳腺癌中VEGF-D的表达与微血管密度、微淋巴管密度的关系.贵州医药,2015,39:499-501.
[14]King A D,Chow S K K,Yu K H,et al.DCE-MRI for Pre-Treatment Prediction and Post-Treatment Assessment of Treatment Response in Sites of Squamous Cell Carcinoma in the Head and Neck.Plos One,2015,10:e0144770.
[15]朱辉严,谌力群,ZUIHui-yan,等.乳腺癌DCE-MR征象分析及其与微血管密度的关系研究.中国CT和MRI杂志,2016,14:71-74.
[2]Min J K,Su M Y,Yu H J,et al.US-localized diffuse optical tomography in breast cancer:comparison with pharmacokinetic parameters of DCE-MRI and with pathologic biomarkers.BMC Cancer,2016,16:1-9.
[3]翁利华,冯建钜,潘瑞根.MRI参数对乳腺癌诊断临床价值分析.医学影像学杂志,2016,26:1538-1541.
[4]An YY,Kim SH,Kang BJ,et al.Treatment response evaluation of breast cancer after neoadjuvant chemotherapy and usefulness of the imaging parameters of MRI and PET/CT.Journal of Korean Medical Science,2015,30:808-815.
[5]Shao G,Fan L,Zhang J,et al.Association of DW/DCE-MRI features with prognostic factors in breast cancer.International Journal of Biological Markers,2016,32:e118.
[6]詹晓娟,余研,戴益琛,等.结直肠癌组织中PTEN、VEGF-A、MVD表达与临床病理参数的关系.癌症进展,2016,14:1239-1242.
[7]Tudorica A,Oh K Y,Chui S Y,et al.Early Prediction and Evaluation of Breast Cancer Response to Neoadjuvant Chemotherapy Using Quantitative DCE-MRI.Translational Oncology,2016,9:8-17.
[8]张凌,范萍,梁娜.DCE-MRI对乳腺癌患者预后评估的价值研究.实用癌症杂志,2015,30:1593-1596.
[9]刘平贤,门琤,郭满.乳腺癌患者血清VEGF、PRL、HER2、TPS、sC D40L及MVD与复发转移的相关性研究.中国妇幼保健,2015,30:1377-1379.
[10]Galbán C J,Ma B,Malyarenko D,et al.Multi-site clinical evaluation of DW-MRI as a treatment response metric for breast cancer patients undergoing neoadjuvant chemotherapy.Plos One,2015,10:e0122151.
[11]Yin J,Yang J,Lu H,et al.Quantitative discrimination between invasive ductal carcinomas and benign lesions based on semi-automatic analysis of time intensity curves from breast dynamic contrast enhanced MRI.Journal of Experimental&Clinical Cancer Research,2015,34:1-10.
[12]Petrillo A,Fusco R,Petrillo M,et al.Standardized Index of Shape(SIS):a quantitative DCE-MRI parameter to discriminate responders by nonresponders after neoadjuvant therapy in LARC.European Radiology,2015,25:1935.
[13]段筱娟,李志义,杨玉涛,等.乳腺癌中VEGF-D的表达与微血管密度、微淋巴管密度的关系.贵州医药,2015,39:499-501.
[14]King A D,Chow S K K,Yu K H,et al.DCE-MRI for Pre-Treatment Prediction and Post-Treatment Assessment of Treatment Response in Sites of Squamous Cell Carcinoma in the Head and Neck.Plos One,2015,10:e0144770.
[15]朱辉严,谌力群,ZUIHui-yan,等.乳腺癌DCE-MR征象分析及其与微血管密度的关系研究.中国CT和MRI杂志,2016,14:71-74.