De Felice C, Cipolla V, Guerrieri D, Santucci D, Musella A, Porfiri L M, Meggiorini M L
Eur J Gynaecol Oncol. 2014;35(4):408-14.
The aim of the study was to evaluate whether the apparent diffusion coefficient (ADC) provided by 3.0 Tesla diffusion-weighted imaging (3T DWI) varies with the prognostic factors Ki67 and grading in invasive breast cancer.
Seventy-three patients with 75 invasive breast cancer lesions who had undergone 3.0 Tesla magnetic resonance imaging (MRI) for local staging were enrolled. All lesions were confirmed by histologic and immunohistochemical analysis. MRI included both dynamic contrast-enhanced and DWI sequences. ADC value was obtained for each lesion. Histologic tumor grade was established according to the Nottingham Grading System (NGS), while Ki67 expression was evaluated by MM1 clone IgG1 mouse anti-human monoclonal antibody. Patients were divided into the following groups: grade 1 (G1), grade 2 (G2), grade 1 plus grade 2 (G1+G2) and grade 3 (G3), and low Ki67 (< or = 14%), intermediate Ki67 (15%-30%), and high Ki67 (> or = 30%). ADC values were compared with the G and Ki67 groups. Statistical comparison was carried out using the Mann-Whitney U and the Kruskal-Wallis H test.
ADC values were significantly higher in G3 than in G1+G2 tumors; no significant difference was observed when G1, G2, and G3 were compared. There was no statistically significant correlation between ADC values and Ki67 percentage (p > 0.05).
ADC values obtained on 3T DWI correlate with low (G1+G2) and high-grade (G3) invasive breast carcinomas.
ADC may be a helpful tool for identifying high-grade invasive breast carcinoma.
本研究旨在评估3.0特斯拉扩散加权成像（3T DWI）所提供的表观扩散系数（ADC）是否随浸润性乳腺癌的预后因素Ki67和分级而变化。
纳入73例患有75个浸润性乳腺癌病灶且已接受3.0特斯拉磁共振成像（MRI）进行局部分期的患者。所有病灶均经组织学和免疫组化分析确诊。MRI包括动态对比增强和DWI序列。获取每个病灶的ADC值。根据诺丁汉分级系统（NGS）确定组织学肿瘤分级，而通过MM1克隆IgG1小鼠抗人单克隆抗体评估Ki67表达。患者分为以下几组：1级（G1）、2级（G2）、1级加2级（G1+G2）和3级（G3），以及低Ki67（≤14%）、中等Ki67（15%-30%）和高Ki67（≥30%）。将ADC值与G组和Ki67组进行比较。使用曼-惠特尼U检验和克鲁斯卡尔-沃利斯H检验进行统计学比较。
G3肿瘤的ADC值显著高于G1+G2肿瘤；比较G1、G2和G3时未观察到显著差异。ADC值与Ki67百分比之间无统计学显著相关性（p>0.05）。
3T DWI获得的ADC值与低级别（G1+G2）和高级别（G3）浸润性乳腺癌相关。
ADC可能是识别高级别浸润性乳腺癌的有用工具。
