Liang Ting, Hu Bin, Du Hongwen, Zhang Yili
Imaging Center, The First Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi 710061, P.R. China.
Oncol Lett. 2020 Dec;20(6):314. doi: 10.3892/ol.2020.12177. Epub 2020 Oct 1.
The aim of the present study was to investigate the role of edema surrounding breast cancer masses in the prognostic prediction of magnetic resonance imaging (MRI) T2-weighted fat suppression sequence. For this purpose, 80 patients with mass-type breast cancer underwent conventional plain breast MRI, dynamic contrast-enhanced (DCE)-MRI or diffusion-weighted MRI scan. The associations between edema around the mass on MRI T2 fat suppression sequence plain scan and tumor stage, pathological findings, immunohistochemical findings and axillary lymph node metastasis were analyzed. The results revealed the presence of edema around the mass on the MRI T2 fat suppression sequence plain scan in 35 patients. By contrast, there was no abnormal enhancement on the DCE-MRI, and the apparent diffusion coefficient value did not decrease in these areas. Compared with the remaining 45 patients, the 35 patients with peritumoral edema exhibited a higher tumor stage and a higher rate of axillary lymph node metastasis (all P<0.05). However, there was no significant difference in pathological classification or the expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (as determined by immunohistochemistry) between the two groups. In total, 12 cases of tumor shrinkage during neoadjuvant chemotherapy were accompanied by an improvement in edema. Taken together, the findings of the present study indicated that the presence of edema around the mass on the MRI T2 fat suppression sequence may predict poor prognosis in patients with mass-type breast cancer. Furthermore, the improvement of the peritumoral edema post-neoadjuvant chemotherapy may also be a predictor of a more favorable prognosis.
本研究的目的是探讨乳腺癌肿块周围水肿在磁共振成像(MRI)T2加权脂肪抑制序列预后预测中的作用。为此,80例肿块型乳腺癌患者接受了常规乳腺平扫MRI、动态对比增强(DCE)-MRI或扩散加权MRI扫描。分析了MRI T2脂肪抑制序列平扫时肿块周围水肿与肿瘤分期、病理结果、免疫组化结果及腋窝淋巴结转移之间的相关性。结果显示,35例患者在MRI T2脂肪抑制序列平扫时肿块周围存在水肿。相比之下,这些区域在DCE-MRI上无异常强化,表观扩散系数值也未降低。与其余45例患者相比,35例肿瘤周围有水肿的患者肿瘤分期更高,腋窝淋巴结转移率更高(均P<0.05)。然而,两组之间在病理分类或雌激素受体、孕激素受体及人表皮生长因子受体2的表达(通过免疫组化测定)方面无显著差异。新辅助化疗期间共有12例肿瘤缩小的患者其水肿情况也有所改善。综上所述,本研究结果表明,MRI T2脂肪抑制序列上肿块周围存在水肿可能预示肿块型乳腺癌患者预后不良。此外,新辅助化疗后肿瘤周围水肿的改善也可能是预后更良好的一个预测指标。