Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China.
GE healthcare (China), Beijing, 100176, China.
BMC Med Imaging. 2023 Jun 1;23(1):70. doi: 10.1186/s12880-023-01022-5.
BACKGROUND: Triple-negative breast cancer (TNBC) is highly malignant and has a poor prognosis due to the lack of effective therapeutic targets. Androgen receptor (AR) has been investigated as a possible therapeutic target. This study quantitatively assessed intratumor heterogeneity by histogram analysis of pharmacokinetic parameters and texture analysis on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to discriminate TNBC from non-triple-negative breast cancer (non-TNBC) and to identify AR expression in TNBC. METHODS: This retrospective study included 99 patients with histopathologically proven breast cancer (TNBC: 36, non-TNBC: 63) who underwent breast DCE-MRI before surgery. The pharmacokinetic parameters of DCE-MRI (K, K and V) and their corresponding texture parameters were calculated. The independent t-test, or Mann-Whitney U-test was used to compare quantitative parameters between TNBC and non-TNBC groups, and AR-positive (AR+) and AR-negative (AR-) TNBC groups. The parameters with significant difference between two groups were further involved in logistic regression analysis to build a prediction model for TNBC. The ROC analysis was conducted on each independent parameter and the TNBC predicting model for evaluating the discrimination performance. The area under the ROC curve (AUC), sensitivity and specificity were derived. RESULTS: The binary logistic regression analysis revealed that K (p = 0.032) and V (p = 0.005) were significantly higher in TNBC than in non-TNBC. The AUC of the combined model for identifying TNBC was 0.735 (p < 0.001) with a cut-off value of 0.268, and its sensitivity and specificity were 88.89% and 52.38%, respectively. The value of K (p = 0.049), K (p = 0.049), and V (p = 0.008) were higher in AR + TNBC group than in AR-TNBC group. CONCLUSION: Histogram and texture analysis of breast lesions on DCE-MRI showed potential to identify TNBC, and the specific features can be possible predictors of AR expression, enhancing the ability to individualize the treatment of patients with TNBC.
背景：三阴性乳腺癌（TNBC）恶性程度高，预后差，缺乏有效的治疗靶点。雄激素受体（AR）已被研究为一种可能的治疗靶点。本研究通过直方图分析药代动力学参数和动态对比增强磁共振成像（DCE-MRI）的纹理分析来定量评估肿瘤内异质性，以区分 TNBC 与非三阴性乳腺癌（non-TNBC），并确定 TNBC 中的 AR 表达。
方法：本回顾性研究纳入了 99 例经病理证实的乳腺癌患者（TNBC：36 例，non-TNBC：63 例），这些患者在术前均接受了乳腺 DCE-MRI 检查。计算 DCE-MRI 的药代动力学参数（K、K 和 V）及其相应的纹理参数。采用独立样本 t 检验或 Mann-Whitney U 检验比较 TNBC 组与 non-TNBC 组、AR 阳性（AR+）和 AR 阴性（AR-）TNBC 组之间的定量参数。将两组间有显著差异的参数进一步纳入逻辑回归分析，建立 TNBC 预测模型。对每个独立参数和 TNBC 预测模型进行 ROC 分析，以评估其鉴别性能。得出 ROC 曲线下面积（AUC）、敏感性和特异性。
结果：二元逻辑回归分析显示，TNBC 组的 K（p=0.032）和 V（p=0.005）显著高于 non-TNBC 组。识别 TNBC 的联合模型的 AUC 为 0.735（p<0.001），截断值为 0.268，其敏感性和特异性分别为 88.89%和 52.38%。AR+TNBC 组的 K（p=0.049）、K（p=0.049）和 V（p=0.008）值均高于 AR-TNBC 组。
结论：DCE-MRI 上乳腺病变的直方图和纹理分析显示出识别 TNBC 的潜力，其特定特征可能是 AR 表达的潜在预测指标，增强了对 TNBC 患者个体化治疗的能力。
Mol Cell Endocrinol. 2021-7-1
Eur Rev Med Pharmacol Sci. 2021-2
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