术前磁共振成像中乳腺实质信号增强率：与三阴性乳腺癌患者早期复发的关联
Breast parenchymal signal enhancement ratio at preoperative magnetic resonance imaging: association with early recurrence in triple-negative breast cancer patients.
作者信息
Park Vivian Youngjean, Kim Eun-Kyung, Kim Min Jung, Yoon Jung Hyun, Moon Hee Jung
机构信息
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
出版信息
Acta Radiol. 2016 Jul;57(7):802-8. doi: 10.1177/0284185115609803. Epub 2015 Oct 28.
BACKGROUND
The signal enhancement ratio (SER) of surrounding non-tumor parenchyma at breast magnetic resonance imaging (MRI) can be helpful in breast cancer patients, but has not been investigated in patients with triple negative breast cancer (TNBC).
PURPOSE
To investigate the association between background parenchymal SER around the tumor on preoperative dynamic contrast-enhanced MRI with recurrence-free survival in patients with TNBC.
MATERIAL AND METHODS
Between April 2012 and May 2013, 71 TNBC patients who underwent preoperative MRI were included. SER values were calculated from regions of interest placed in the breast parenchyma around the tumor. Cox proportional hazards models were used to determine associations between MRI variables, clinical-pathologic variables, and recurrence-free survival.
RESULTS
Recurrence occurred in 8.5% (6/71) of patients. At univariate analysis, a higher SER around the tumor, larger tumor size, lymphovascular invasion, lymph node metastasis, receipt of neoadjuvant chemotherapy, receipt of total mastectomy, and not receiving adjuvant chemotherapy were associated with worse recurrence-free survival. At multivariate analysis of preoperative variables, a higher SER around the tumor was independently associated with worse recurrence-free survival (hazard ratio [HR] = 7.072, P = 0.003 for SER1; HR = 6.268, P = 0.006 for SER2; HR = 3.004, P = 0.039 for SER3).
CONCLUSION
Higher SER around the tumor at preoperative dynamic contrast-enhanced MRI is an independent predictor for recurrence in TNBC patients.
背景
乳腺磁共振成像（MRI）中周围非肿瘤实质的信号增强率（SER）对乳腺癌患者可能有帮助，但尚未在三阴性乳腺癌（TNBC）患者中进行研究。
目的
探讨术前动态对比增强MRI上肿瘤周围背景实质SER与TNBC患者无复发生存率之间的关联。
材料与方法
纳入2012年4月至2013年5月期间接受术前MRI检查的71例TNBC患者。从置于肿瘤周围乳腺实质的感兴趣区域计算SER值。采用Cox比例风险模型确定MRI变量、临床病理变量与无复发生存率之间的关联。
结果
8.5%（6/71）的患者出现复发。单因素分析显示，肿瘤周围较高的SER、较大的肿瘤大小、淋巴管浸润、淋巴结转移、接受新辅助化疗、接受全乳切除术以及未接受辅助化疗与较差的无复发生存率相关。在术前变量的多因素分析中，肿瘤周围较高的SER与较差的无复发生存率独立相关（SER1的风险比[HR]=7.072，P=0.003；SER2的HR=6.268，P=0.006；SER3的HR=3.004，P=0.039）。
结论
术前动态对比增强MRI上肿瘤周围较高的SER是TNBC患者复发的独立预测因素。
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