保乳治疗后局部复发的预测：术前MRI上肿瘤周围实质信号增强率（SER）
Predicting local recurrence following breast-conserving treatment: parenchymal signal enhancement ratio (SER) around the tumor on preoperative MRI.
作者信息
Kim Mi Young, Cho Nariya, Koo Hye Ryoung, Yun Bo La, Bae Min Sun, Chie Eui Kyu, Moon Woo Kyung
机构信息
Department of Radiology.
出版信息
Acta Radiol. 2013 Sep;54(7):731-8. doi: 10.1177/0284185113483676. Epub 2013 Apr 30.
BACKGROUND
The level of background parenchymal enhancement around tumor is known to be associated with breast cancer risk. However, there is no study investigating predictive power of parenchymal signal enhancement ratio (SER) around tumor for ipsilateral breast tumor recurrence (IBTR).
PURPOSE
To investigate whether the breast parenchymal SER around the tumor on preoperative dynamic contrast-enhanced magnetic resonance imaging (MRI) is associated with subsequent IBTR in breast cancer patients who had undergone breast-conserving treatment.
MATERIAL AND METHODS
Nineteen consecutive women (mean age, 44 years; range, 34-63 years) with breast cancer who developed IBTR following breast-conserving treatment and 114 control women matched for age, as well as T and N stages were included. We compared the clinicopathologic features of the two groups including nuclear grade, histologic grade, hormonal receptor status, human epidermal growth factor receptor-2 (HER-2) status, lymphovascular invasion, negative margin width, use of adjuvant therapy, and parenchymal SER around the tumor on preoperative DCE-MRI. The SER was measured on a slice showing the largest dimension of the tumor. Multivariate conditional logistic regression analysis was used to identify independent factors associated with IBTR.
RESULTS
In univariate analysis, ER negativity (odds ratio [OR] = 4.7; P = 0.040), PR negativity (OR = 4.0; P = 0.013), HER-2 positivity (OR = 3.6; P = 0.026), and a parenchymal SER greater than 0.53 (OR = 23.3; P = 0.011) were associated with IBTR. In multivariate analysis, ER negativity (OR = 3.8; P = 0.015) and a parenchymal SER greater than 0.53 (OR = 13.2; P = 0.040) on preoperative MRI were independent factors associated with IBTR.
CONCLUSION
In addition to ER negativity, a higher parenchymal SER on preoperative MRI was an independent factor associated with subsequent IBTR in patients with breast cancer who had undergone breast-conserving treatment.
背景
已知肿瘤周围乳腺实质的强化水平与乳腺癌风险相关。然而，尚无研究探讨肿瘤周围实质信号增强率（SER）对同侧乳腺肿瘤复发（IBTR）的预测能力。
目的
探讨术前动态对比增强磁共振成像（MRI）上肿瘤周围乳腺实质SER是否与接受保乳治疗的乳腺癌患者随后的IBTR相关。
材料与方法
纳入19例保乳治疗后发生IBTR的连续乳腺癌女性患者（平均年龄44岁；范围34 - 63岁）以及114例年龄、T分期和N分期相匹配的对照女性。我们比较了两组的临床病理特征，包括核分级、组织学分级、激素受体状态、人表皮生长因子受体2（HER-2）状态、淋巴管浸润、切缘阴性宽度、辅助治疗的使用情况以及术前DCE-MRI上肿瘤周围的实质SER。SER在显示肿瘤最大径的层面上进行测量。采用多变量条件逻辑回归分析来确定与IBTR相关的独立因素。
结果
单变量分析中，雌激素受体（ER）阴性（比值比[OR]=4.7；P = 0.040）、孕激素受体（PR）阴性（OR = 4.0；P = 0.013）、HER-2阳性（OR = 3.6；P = 0.026）以及实质SER大于0.53（OR = 23.3；P = 0.011）与IBTR相关。多变量分析中，术前MRI上ER阴性（OR = 3.8；P = 0.015）以及实质SER大于0.53（OR = 13.2；P = 0.040）是与IBTR相关的独立因素。
结论
除ER阴性外，术前MRI上较高的实质SER是接受保乳治疗的乳腺癌患者随后发生IBTR的独立相关因素。
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