乳腺导管原位癌MRI表现与p53表达及临床病理的关系

The Relationship between MRI Findings,p53 Expression,and Clinical Pathology of Ductal Carcinoma in Situ of the Breast

王小英 ¹顾海玉 ²金红玉¹

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作者信息

1. 南昌市人民医院CT室江西南昌 330008
2. 江西省妇幼保健院影像科江西南昌 330006
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摘要

目的:探讨分析乳腺导管原位癌(DCIS)磁共振成像(MRI)表现与p53 蛋白(p53)表达及临床病理的关系.方法:回顾性研究 60 例 2018 年 1 月—2021 年 12 月在南昌市人民医院经手术病理证实的DCIS患者的乳腺MRI平扫+增强的资料,观察记录患者病理分级和MRI表现[动态增强曲线、早期强化率、表观弥散系数(ADC)、病灶形态学],采用免疫组化法检测癌组织p53 表达情况,分析MRI表现与p53 表达及临床病理的关系.结果:DCIS患者MRI表现主要为非肿块强化 37 例(61.67%,37/60),以节段性强化(19 例,51.35%)和簇环强化(17 例,45.95%)为主.动态增强曲线主要以Ⅰ型为主(25例,41.67%),早期强化率以早期快速强化为主(22例,36.67%).ADC值＜1.0×10-3 mm2/s较多,占 65.00%(39/60).p53 阳性、高核级别中TIC类型为Ⅲ型和早期快速强化占比均显著高于p53 阴性、非高核级别,差异均有统计学意义(P＜0.05);p53(阳性、阴性)和病理分级(高核级别、非高核级别)在形态学、非肿块强化分布形式和内部强化及ADC比较,差异均无统计学意义(P＞0.05).p53 表达与病理分级有关.高核级别的DCIS患者p53 阳性表达发生率更高,差异有统计学意义(P＜0.05).结论:DCIS患者MRI表现具有特异性,主要表现为节段性分布和簇环强化的非肿块强化,以早期快速强化和I型TIC曲线多为常见.MRI表现与p53 表达和临床病理分级有关,通过分析MRI表现可为DCIS患者的治疗和预后提供参考.

Abstract

Objective:To explore and analyze the relationship between magnetic resonance imaging(MRI)findings,p53 protein(p53)expression and clinicopathology in ductal carcinoma in situ of breast(DCIS).Method:A retrospective study was conducted on MRI plain scan + enhancement data of 60 patients with surgically and pathologically confirmed DCIS in Nanchang People's Hospital between January 2018 and December 2021,the pathological grading and MRI findings[dynamic enhancement curve,early enhancement rate,apparent diffusion coefficient(ADC),focal morphology]of patients were observed and recorded,the expression of p53 in carcinoma tissues was detected by immunohistochemistry,the relationship between MRI findings,p53 expression and clinicopathology was analyzed.Result:The main MRI findings in DCIS patients were non-mass enhancement[37 cases(61.67%,37/60)],which was mainly on segmental enhancement(19 cases,51.35%)and cluster-ring enhancement(17 cases,45.95%).The dynamic enhancement curves were mainly on type Ⅰ(25 cases,41.67%),and early enhancement rate was mainly on fast enhancement(22 cases,36.67%).The proportion of cases with ADC value＜1.0×10-3 mm2/s was high[65.00%(39/60)].The proportions of type Ⅲ TIC and early fast enhancement in p53 positive and high nuclear grading were significantly higher than those in p53 negative and non-high nuclear grading,the differences were statistically significant(P＜0.05);but there were not significant differences in morphology,distribution of non-mass enhancement,internal enhancement or ADC among patients with different p53 expression(positive,negative)and pathological grading(high nuclear grade,non-high nuclear grade)(P＞0.05).The expression of p53 was related to pathological grading.The incidence of p53 positive was higher in patients with high nuclear grade of DCIS,the difference was statistically significantly(P＜0.05).Conclusion:MRI findings are specific in DCIS patients,which are mainly characterized by non-mass enhancement with segmental distribution and cluster-ring enhancement,and early fast enhancement and type Ⅰ TIC curves are common.MRI findings are related to p53 expression and pathological grade.The analysis of MRI findings can provide reference for the treatment and prognosis of DCIS patients.

关键词

乳腺导管原位癌/磁共振成像/p53蛋白/病理分级

Key words

Ductal carcinoma in situ of breast/Magnetic resonance imaging/p53 protein/Pathological grading

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出版年

2024

中国医学创新

中国保健协会

中国医学创新

影响因子：1.706

ISSN：1674-4985

参考文献量20

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