摘要
目的 评价基于动态增强磁共振成像(DCE-MRI)的定量、半定量参数在鉴别HER2阳性乳腺癌中的作用.方法 采用回顾性研究方法,收集女性乳腺癌患者147例.所有患者接受3.0T MRI检查,采集到的DCE-MRI的参数包括:容积转运常数(Ktrans)、速率常数(kep)、血管外细胞外容积分数(Ve)、血浆容积分数(Vp)、达峰时间(TTP)、最大浓度(MAX Conc)、增强曲线下初始面积(AUC)、最大斜率(MAX Slope).将患者分别分为两组(HER2阳性组vs.非HER2阳性组).采用单因素分析参数组间差异;进一步采用二元Logistic回归,并构建联合诊断模型,评估DCE-MRI定量、半定量参数及联合诊断模型鉴别HER2阳性乳腺癌的价值.结果 两组的组间比较中,8个定量、半定量参数具有统计学差异;kep、TTP和联合模型对于HER2阳性乳腺癌具有诊断价值(AUC=0.763、0.733、0.832,经DeLong检验比较,P均＜0.020).结论 DCE-MRI定量参数、半定量参数是HER2阳性乳腺癌的独立诊断因素;kep、TTP和联合诊断模型对HER2阳性乳腺癌具有诊断价值,且联合模型的诊断效能更高.
Abstract
Objective To evaluate the role of quantitative and semi quantitative parameters based on dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)in discriminating three negative breast cancer and HER2 positive breast cancer.Methods A retrospective study was conducted to collect 147 female breast cancer patients(mean age 52.91±28.09 years).All patients underwent 3.OT MRI examination.The parameters of DCE-MRI included:volume transport constant(Ktrans),rate constant(kep),extravascular extracellular volume fraction(ve),plasma volume fraction(vp),time to peak(TTP),maximum concentration(Max conc),initial area under enhancement curve(AUC),time to peak(TTP)The maximum slope has four semi quantitative parameters.According to the results of immunohistochemistry,the patients were divided into 2 groups(HER2 positive group vs non HER2 positive group).Univariate analysis was used to analyze the differences between groups;Two variables Logistic regression was used to deal with data with statistical difference between groups,and to study the value of parameters in molecular typing of breast cancer.Results Ktrans,kep,ve,vp,TTP,MAX Conc,AUC,and MAX Slope were statistically different between the HER2-positive breast cancer group and the non-HER2-positive breast cancer group.kep,TTP and the combined model were diagnostic for HER2-positive breast cancer(AUC=0.763,0.733,0.832,all P＜0.020,by DeLong test).Conclusion DCE-MRI quantitative parameters and semi-quantitative parameters are independent diagnostic factors of HER2-positive breast cancer.The kep,TTP and combination diagnostic models have diagnostic value for HER2-positive breast cancer,and the combined models have higher diagnostic efficiency.
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