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学科主题: 影像医学
题名:
乳腺癌新辅助化疗前后MR表观扩散系数及癌灶最大径与Ki-67表达的相关性研究
其他题名: The study of relationship between apparent diffusion coefficient value and maximal diameter of the breast cancer with Ki-67 expression during neoadjuvant chemotherapy
作者: 郭丽; 王霄英; 秦乃珊; 蒋学祥
关键词: 乳腺肿瘤 ; 磁共振成像 ; 对比研究 ; Breast neoplasms ; Magnetic resonance imaging ; Comparative study
刊名: 中华放射学杂志
发表日期: 2011
DOI: 10.3760/cma.j.issn.1005-1201.2011.12.009
卷: 45, 期:12, 页:1113-1116
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 探讨乳腺癌患者新辅助化疗前后ADC值和癌灶最大径与Ki-67不同表达程度之间的关系.方法 回顾性分析48例穿刺活检证实为乳腺癌的患者资料,患者于新辅助化疔前及化疗第4周期后行MR DWI及增强扫描.测量化疗前后癌灶的ADC值及最大径,并计算其变化率△ADC%和△D%.利用Ki-67指数不同,将所有癌灶分为A、B、C三组:A组Ki-67< 20%,B组Ki-67为20% ~ 60%,C组Ki-67> 60%.采用非参数检验比较3组癌灶化疗前后ADC值、△ADC%、最大径及△D%的差异.结果 化疗前A组(15例)癌灶的ADC值为1.1 × 10-3 mm2/s[(0.9×10-3~1.2×10-3)mm2/s],高于B组[8例,0.9×10-3 mm2/s(0.9×10-3~1.0×10-3) mm2/s]和C组[25例,0.9×10-3mm2/s(0.7 × 10-3~1.2×10-3)mm2/s],差异有统计学意义(P<0.05);而化疗后C组癌灶的ADC值为1.3×10-3 mm2/s[(0.2×10-3 ~ 1.4×10-3)mm2/s],高于A组[1.1×10-3 mm2/s,(1.0× 10-3 ~ 1.2×10-3)mm2/s]和B组[1.1×10-3 mm2/s(1.0×10-3~1.1×10-3)mm2/s],差异具有统计学意义(P<0.01);化疗前后C组癌灶的ADC变化率为45.5%(- 12.0%~78.6%),大于A组[45.5%(- 12.0% ~ 78.6%)]和B组[45.5%(- 12.0%~78.6%)],差异具有统计学意义(P<0.01).化疗前、后癌灶的最大径A组分别为2.2 cm(2.0~2.4 cm)和1.0 cm(0.0~ 1.4 cm),均小于B组[化疗前3.7 cm(3.6~3.9 cm),化疗后2.9 cm(0.0 ~3.1 cm)]和C组[化疗前3.4 cm(2.7 ~4.2 cm),化疗后1.9 cm(0.0 ~2.2 cm)],且差异具有统计学意义(P<0.05);B组癌灶化疗后最大径的变化率为21.6%(- 15.2% ~ 27.5%),小于A组[52.7%(-23.6% ~72.1%)](P<0.01)和C组[51.2%(- 10.3%~92.6%)](P<0.05),差异具有统计学意义.结论 对于Ki-67指数不同表达程度的癌灶,新辅助化疗前、后癌灶的ADC值不同,癌灶的ADC值及最大径线对于化疗的反应不同,差异具有统计学意义. Objective Study the ADC value and the maximal diameter and their changes of breast cancer before and after neoadjuvant chemotherapy,to determine the relationship with different expression level of Ki-67.Methods Forty eight patients with breast cancer confirmed by biopsy underwent MR DWI and enhanced scan before and after 4 cycles neoadjuvant chemotherapy.Review the MR images retrospectively.The ADC value and the maximum diameter( D)of the cancer foci were measured before and after chemotherapy,and the rate of their changes △ADC% and △D% were calculated.Using different Ki-67 index level,all the foci were divided into three groups:group A with Ki-67 < 20%,group B with Ki-67 between 20% and 60%,and group C with Ki-67 > 60%.Using nonparameter test to compare the ADC values,△ADC%,D and △D% of the three groups before and after chemotherapy,determine whether there were differences.ResultsBefore chemotherapy,the ADC value of group A ( n = 15 ) was 1.1 ×10-3 mm2/s[ (0.9 × 10-3—1.2 × 10-3) mm2/s],which was higher than that of group B[n = 8,0.9 ×10-3 mm2/s(0.9 × 10-3-1.0 × 10-3) mm2/s] and C [n =25,0.9 × 10-3 mm2/s(0.7 × 10-3—1.2 ×10-3) mm2/s],and the difference was statistically significant (P <0.05 ) ; while the ADC value of group C after chemotherapy was 1.3 × 10 -3 mm2/s[ (0.2 × 10 -3—1.4 × 10 -3 ) mm2/s],which was higher than that of group A [1.1 × 10-3 mm2/s,(1.0 × 10-3—1.2 × 10-3) mm2/s] and B[1.1 × 10-3 mm2/s,( 1.0 × 10-3-1.1 × 10 -3 ) mm2/s],and the differences were statistically significance ( P < 0.01 ) ; the ADC change rate( △ADC% ) of group C was 45.5% ( - 12.0% —78.6% ),which was greater than group A [45.5% ( - 12.0%—78.6% ) ] and B [ 45.5% ( - 12.0%—78.6% ) ],the difference was significant (P < 0.01 ).The maximum diameters of group A were 2.2 cm (2.0—2.4 cm)and 1.0 cm(0.0—1.4 cm)before and after chemotherapy,lower than those of group B [ 3.7 cm ( 3.6—3.9 cm ) before NAC,2.9 cm (0.0-3.1 em) after NAC] and group C[3.4 cm(2.7—4.2 cm) before NAC,1.9 cm(0.0—2.2 cm) after NAC ],and the differences were statistically significant ( P < 0.05 ) ; the change rate of the maximum diameter in group B was 21.6% ( - 15.2%—27.5% ),which was less than group A [52.7% ( -23.6%—72.1%)] (P<0.01) and C [51.2% ( -10.3%—92.6%)] (P <0.05),and the difference was statistically significant.Conclusion The ADC values and the maximal diameter of breast cancer differed with different expression levels of Ki-67 index before and after neoadjuvant chemotherapy,and the response to neoadjuvant chemotherapy of which varied as well.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/42587
Appears in Collections:北京大学第一临床医学院_医学影像科_期刊论文

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作者单位: 100034,北京大学第一医院医学影像科
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