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MRI在乳腺癌患者分期中的作用:组织学类型和分子亚型有影响吗?

Role of MRI in the staging of breast cancer patients: does histological type and molecular subtype matter?

作者信息

Bitencourt Almir G V, Pereira Nara P, França Luciana K L, Silva Caroline B, Paludo Jociana, Paiva Hugo L S, Graziano Luciana, Guatelli Camila S, Souza Juliana A, Marques Elvira F

机构信息

Department of Diagnostic Imaging, A C Camargo Cancer Center, São Paulo, Brazil.

出版信息

Br J Radiol. 2015;88(1055):20150458. doi: 10.1259/bjr.20150458. Epub 2015 Sep 16.

Abstract

OBJECTIVE

To assess the role of MRI in the pre-operative staging of patients with different histological types and molecular subtypes of breast cancer, by the assessment of the dimensions of the main tumour and identification of multifocal and/or multicentric disease.

METHODS

The study included 160 females diagnosed with breast cancer who underwent breast MRI for pre-operative staging. The size of the primary tumour evaluated by MRI was compared with the pathology (gold standard) using the Pearson's correlation coefficient (r). The presence of multifocal and/or multicentric disease was also evaluated.

RESULTS

The mean age of patients was 52.6 years (range 30-81 years). Correlation between the largest dimension of the main tumour measured by MRI and pathology was worse for non-special type/invasive ductal carcinoma than for other histological types and was better for luminal A and triple-negative than for luminal B and Her-2 molecular subtypes. Multifocal and/or multicentric disease was present in 48 patients (30.0%), and it was more common in breast carcinomas classified as Her-2 molecular subtype. There was no statistically significant difference in the frequency of multifocal and/or multicentric tumours identified only by MRI in relation to histological type or molecular subtype.

CONCLUSION

The results of this retrospective study demonstrated that histological types and molecular subtypes might influence the MRI assessment of breast cancers, especially in the evaluation of tumour size.

ADVANCES IN KNOWLEDGE

The real benefit of MRI for treatment planning in patients with breast cancer may be different according to the histological type and molecular subtype.

摘要

目的

通过评估主要肿瘤的大小以及识别多灶性和/或多中心性疾病,评估磁共振成像(MRI)在不同组织学类型和分子亚型乳腺癌患者术前分期中的作用。

方法

该研究纳入了160例经诊断为乳腺癌且接受乳腺MRI进行术前分期的女性患者。使用Pearson相关系数(r)将MRI评估的原发肿瘤大小与病理结果(金标准)进行比较。同时也评估了多灶性和/或多中心性疾病的存在情况。

结果

患者的平均年龄为52.6岁(范围30 - 81岁)。对于非特殊类型/浸润性导管癌,MRI测量的主要肿瘤最大径与病理结果之间的相关性比其他组织学类型更差,对于腔面A型和三阴性乳腺癌,其相关性优于腔面B型和Her-2分子亚型。48例患者(30.0%)存在多灶性和/或多中心性疾病,在归类为Her-2分子亚型的乳腺癌中更为常见。仅通过MRI识别的多灶性和/或多中心性肿瘤的频率在组织学类型或分子亚型方面无统计学显著差异。

结论

这项回顾性研究的结果表明,组织学类型和分子亚型可能会影响乳腺癌的MRI评估,尤其是在肿瘤大小的评估方面。

知识进展

MRI在乳腺癌患者治疗规划中的实际益处可能因组织学类型和分子亚型而异。

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