Alduk Ana Marija, Brcic Iva, Podolski Paula, Prutki Maja
a Department of Radiology , University Hospital Centre Zagreb, University of Zagreb School of Medicine , Zagreb , Croatia.
b Department of Pathology , Medical University of Graz , Graz , Austria.
Acta Clin Belg. 2017 Oct;72(5):306-312. doi: 10.1080/17843286.2016.1266432. Epub 2016 Dec 20.
The aim of this study was to correlate magnetic resonance imaging (MRI) features of invasive ductal carcinomas (IDC) with pathohistological prognostic factors. Such an association, if present, could have significant translational implications for early identification of aggressive types of breast cancer.
One hundred and fourteen consecutive women with IDC who underwent breast MRI within one month prior to surgery were included in this retrospective study. MRI features were analyzed and then interpreted with a Göttingen score (GS) that included morphological (shape, margins, and pattern of enhancement) and kinetic characteristics (initial signal increase and post-initial behavior of the time-signal intensity curve). Histological specimens were analyzed for tumor size, axillary lymph node status, histological grade, estrogen receptors (ER), progesterone receptors (PR), HER2, and Ki-67.
By multivariate analysis, a smooth margin was a significant, independent predictor of a larger tumor size (p = 0.041), lymph node invasion (p = 0.013), and lower expression of ER (p = 0.022). High GS was a significant, independent predictor of a higher histological grade (p = 0.022) while round or oval shape of lesion was independent predictor of a higher PR expression (p = 0.027).
A smooth margin of breast cancer on breast MRI was able to predict positive axillary lymph nodes, larger tumor size, and lower expression of ER. Except for a higher histological grade, GS was not able to predict other unfavorable prognostic factors, probably due to the fact that smooth margins were assigned fewer points than spiculated margins.
本研究旨在将浸润性导管癌（IDC）的磁共振成像（MRI）特征与病理组织学预后因素相关联。如果存在这种关联，对于早期识别侵袭性乳腺癌类型可能具有重要的转化意义。
本回顾性研究纳入了114例在手术前1个月内接受乳腺MRI检查的连续IDC女性患者。分析MRI特征，然后用哥廷根评分（GS）进行解读，该评分包括形态学（形状、边缘和强化模式）和动力学特征（初始信号增加以及时间-信号强度曲线的初始后行为）。对组织学标本进行肿瘤大小、腋窝淋巴结状态、组织学分级、雌激素受体（ER）、孕激素受体（PR）、HER2和Ki-67分析。
通过多变量分析，边缘光滑是肿瘤较大（p = 0.041）、淋巴结侵犯（p = 0.013）和ER表达较低（p = 0.022）的显著独立预测因素。高GS是组织学分级较高（p = 0.022）的显著独立预测因素，而病变呈圆形或椭圆形是PR表达较高的独立预测因素（p = 0.027）。
乳腺MRI上乳腺癌边缘光滑能够预测腋窝淋巴结阳性、肿瘤较大和ER表达较低。除了较高的组织学分级外，GS无法预测其他不良预后因素，可能是因为边缘光滑比边缘毛刺状的得分少。
