Ayoub Yazan, Cheung Sai Man, Maglan Boddor, Senn Nicholas, Chan Kwok-Shing, He Jiabao
Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom.
Newcastle Magnetic Resonance Centre, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom.
Front Oncol. 2024 Dec 17;14:1475090. doi: 10.3389/fonc.2024.1475090. eCollection 2024.
Ductal carcinoma (DCIS) accounts for 25% of newly diagnosed breast cancer cases with only 14%-53% developing into invasive ductal carcinoma (IDC), but currently overtreated due to inadequate accuracy of mammography. Subtypes of calcification, discernible from histology, has been suggested to have prognostic value in DCIS, while the lipid composition of saturated and unsaturated fatty acids may be altered in synthesis with potential sensitivity to the difference between DCIS and IDC. We therefore set out to examine calcification using ultra short echo time (UTE) MRI and lipid composition using chemical shift-encoded imaging (CSEI), as markers for histological calcification classification, in the initial step towards application.
Twenty female patients, with mean age (range) of 57 (35-78) years, participated in the study. Intra- and peri-tumoural degree of calcification and peri-tumoural lipid composition were acquired on MRI using UTE and CSEI, respectively. imaging was conducted on the freshly excised breast tumour specimens immediately after surgery. Histopathological analysis was conducted to determine the calcification status, Nottingham Prognostic Index (NPI), and proliferative activity marker Ki-67.
Intra-tumoural degree of calcification in malignant classification (1.05 ± 0.13) was significantly higher (p = 0.012) against no calcification classification (0.84 ± 0.09). Peri-tumoural degree of calcification in malignant classification (1.64 ± 0.10) was significantly higher (p = 0.033) against no calcification classification (1.41 ± 0.18). Peri-tumoural MUFA in malignant classification (0.40 ± 0.01) was significantly higher (p = 0.039) against no calcification classification (0.38 ± 0.02). Ki-67 showed significant negative correlation against peri-tumoural MUFA (p = 0.043, ρ = -0.457), significant positive correlation against SFA (p = 0.008, ρ = 0.577), and significant negative correlation against PUFA (p = 0.002, ρ = -0.653).
The intra- and peri-tumoural degree of calcification and peri-tumoural MUFA are sensitive to histological calcification classes supporting future investigation into DCIS prognosis.
导管原位癌（DCIS）占新诊断乳腺癌病例的25%，仅有14%-53%会发展为浸润性导管癌（IDC），但由于乳腺钼靶检查准确性不足，目前存在过度治疗的情况。从组织学上可辨别的钙化亚型被认为在DCIS中具有预后价值，而饱和脂肪酸和不饱和脂肪酸的脂质组成在合成过程中可能发生改变，对DCIS和IDC之间的差异具有潜在敏感性。因此，我们着手使用超短回波时间（UTE）磁共振成像（MRI）检查钙化情况，并使用化学位移编码成像（CSEI）检查脂质组成，作为组织学钙化分类的标志物，这是迈向应用的第一步。
20名平均年龄（范围）为57（35-78）岁的女性患者参与了本研究。分别使用UTE和CSEI在MRI上获取肿瘤内和肿瘤周围的钙化程度以及肿瘤周围的脂质组成。成像在手术后立即对新鲜切除的乳腺肿瘤标本上进行。进行组织病理学分析以确定钙化状态、诺丁汉预后指数（NPI）和增殖活性标志物Ki-67。
恶性分类中肿瘤内钙化程度（1.05±0.13）显著高于无钙化分类（0.84±0.09）（p=0.012）。恶性分类中肿瘤周围钙化程度（1.64±0.10）显著高于无钙化分类（1.41±0.18）（p=0.033）。恶性分类中肿瘤周围单不饱和脂肪酸（MUFA）含量（0.40±0.01）显著高于无钙化分类（0.38±0.02）（p=0.039）。Ki-67与肿瘤周围MUFA呈显著负相关（p=0.043，ρ=-0.457），与饱和脂肪酸（SFA）呈显著正相关（p=0.008，ρ=0.577），与多不饱和脂肪酸（PUFA）呈显著负相关（p=0.002，ρ=-0.653）。
肿瘤内和肿瘤周围的钙化程度以及肿瘤周围的MUFA对组织学钙化类别敏感，支持未来对DCIS预后的研究。
