磁共振差异分析在 HER-2 阳性乳腺癌不同激素受体表达状态中的应用。
Magnetic resonance differential analysis for different hormone receptor expression status in HER-2-positive breast cancer.
机构信息
2021 Graduate Class, Hunan University of Traditional Chinese Medicine, Changsha 410208.
Department of Radiotherapy, First Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410021, China.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Jan 28;48(1):68-75. doi: 10.11817/j.issn.1672-7347.2023.220096.
OBJECTIVES
Currently, it is difficult to assess the expression status of hormone receptor (HR) in breast malignant tumors with human epidermal growth factor receptor 2 (HER-2)-positive in the early preoperative stage, and it is difficult to predict whether it is non-invasively. This study aims to explore the value of MRI on the different HR expression status (HR/HR) in HER-2 positive breast cancer.
METHODS
Thirty patients with HR+ HER-2-positive breast cancer (HR+ group) and 23 patients with HR-HER-2-positive breast cancer (HR- group) from the First Hospital of Hunan University of Traditional Chinese Medicine between January 7, 2015 and November 26, 2021 were selected as subjects, and all the patients were examined by MRI and all were confirmed by surgery or pathological biopsy puncture. The immunohistochemical staining results were used as the gold standard to analyze the basic clinical conditions, peri-lesion conditions and MRI sign characteristics in the 2 groups.
RESULTS
There were all significant differences in terms of mass margins, internal reinforcement features, and apparent diffusion coefficient (ADC) values between the HR+ group and the HR- group (all P<0.05). The logistic multivariate regression model showed that: when the lesion presented as a mass-type breast cancer on MRI, the internal enhancement features of the lesion were an independent predictor for differentiation in the 2 types of breast cancer [odds ratio (OR)=5.95, 95% CI: 1.223 to 28.951, P<0.05], and the mass margin (OR=0.386, 95% CI: 0.137 to 1.082, P>0.05) and ADC value (OR=0.234, 95% CI: 0.001 to 105.293, P>0.05) were not the independent predictors in distinguishing the 2 types of breast cancer.
CONCLUSIONS
Multiparametric MRI has good diagnostic value for HR expression status in HER-2-positive breast cancer. Combined logistic regression analysis to construct a predictive model may be helpful to the identical diagnosis.
目的
目前对于人表皮生长因子受体 2（HER-2）阳性早期术前乳腺癌中激素受体（HR）的表达状态评估较为困难，难以进行无创预测。本研究旨在探讨 MRI 对不同 HR 表达状态（HR+/HR-）的 HER-2 阳性乳腺癌的价值。
方法
选取 2015 年 1 月 7 日至 2021 年 11 月 26 日湖南中医药大学第一附属医院收治的 30 例 HR+/HER-2 阳性乳腺癌患者（HR+组）和 23 例 HR-HER-2 阳性乳腺癌患者（HR-组）为研究对象，所有患者均行 MRI 检查，并经手术或病理穿刺活检证实。以免疫组织化学染色结果为金标准，分析两组的基本临床情况、病变周围情况和 MRI 征象特征。
结果
HR+组与 HR-组在肿块边缘、内部强化特征和表观扩散系数（ADC）值方面均有显著差异（均 P<0.05）。多因素逻辑回归模型显示：当 MRI 表现为肿块型乳腺癌时，病变内部强化特征是两种乳腺癌类型区分的独立预测因素[比值比（OR）=5.95，95%可信区间：1.22328.951，P<0.05]，肿块边缘（OR=0.386，95%可信区间：0.1371.082，P>0.05）和 ADC 值（OR=0.234，95%可信区间：0.001~105.293，P>0.05）不是区分两种乳腺癌的独立预测因素。
结论
多参数 MRI 对 HER-2 阳性乳腺癌的 HR 表达状态具有良好的诊断价值。结合逻辑回归分析构建预测模型可能有助于进行同型诊断。
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