Kristina Samaržija, Department of Radiology, Karlovac General Hospital, A. Štampara 3, 47000 Karlovac, Croatia,
Croat Med J. 2021 Feb 28;62(1):59-67. doi: 10.3325/cmj.2021.62.59.
To evaluate the imaging characteristics of desmoplasia on digital breast tomosynthesis (DBT) and their association with the Ki-67 index.
Seventy-seven malignant spiculated breast masses were analyzed in terms of tumor size, length and width of spicules, coverage of tumor margin with spicules, and the number of spicules. The Ki-67 index was obtained from surgically removed tumor specimens.
The average spicule length was significantly negatively associated with a high Ki-67 (P=0.005, odds ratio [OR] 0.252, 95% confidence interval [CI] 0.094-0.676), ie, the lesions with longer spicules had a 3.968 times lower odds of having a high Ki-67 than the lesions with shorter spicules. The average spicule width at the base was significantly positively associated with Ki-67 (P=0.004, OR 3.939, 95% CI 1.520-10.209), ie, the lesions with thick spicules had a 3.939 times higher odds of having a high Ki-67 than the lesions with thin spicules. The lesions with more than 20 spicules and those with partially spiculated margins more frequently had a high Ki-67 than those with fewer spicules and fully spiculated margins, but the differences were not significant.
The spiculation analysis could be used as a non-invasive method providing information about malignant lesions. The tumor proliferative activity, and therefore the patient's prognosis, might be predicted before biopsy directly from DBT images.
评估数字乳腺断层合成（DBT）中纤维组织增生的影像学特征及其与 Ki-67 指数的关系。
分析了 77 例恶性分叶状乳腺肿块的肿瘤大小、分叶长度和宽度、肿瘤边缘的分叶覆盖程度和分叶数量。Ki-67 指数从手术切除的肿瘤标本中获得。
平均分叶长度与 Ki-67 高度显著负相关（P=0.005，优势比[OR]0.252，95%置信区间[CI]0.094-0.676），即分叶较长的病变发生 Ki-67 高的几率比分叶较短的病变低 3.968 倍。基底处平均分叶宽度与 Ki-67 显著正相关（P=0.004，OR 3.939，95%CI 1.520-10.209），即分叶较厚的病变发生 Ki-67 高的几率比分叶较薄的病变高 3.939 倍。分叶数超过 20 个和部分分叶状边缘的病变比分叶数较少和完全分叶状边缘的病变更常发生 Ki-67 高，但差异无统计学意义。
分叶分析可作为一种非侵入性方法，提供关于恶性病变的信息。肿瘤增殖活性，从而预测患者的预后，可在活检前直接从 DBT 图像预测。
