乳腺癌患者动态增强MRI时间-信号强度曲线与肿瘤细胞生物学行为的相关性

doi:10.7517/issn.1674-0475.220318

摘要/Abstract

摘要： 探究乳腺癌患者动态增强MRI时间-信号强度曲线与肿瘤细胞生物学行为的相关性。选取60例乳腺癌患者作为观察组，另选取同期收治的60例乳腺良性病变患者作为对照组，均进行动态增强MRI检查。结果显示，观察组对比剂最大浓度（Max Cone）、时间-信号强度曲线的曲线下面积（AUC）、时间-信号强度曲线的最大斜率（Max Slop）、速率常数（Kep）、转运常数（Ktrans）、血浆容积分数（Vp）高于对照组，达峰时间（TTP）低于对照组（P<0.05）；Ktrans、Kep、Vp、TTP、Max Cone、Max Slop、AUC联合诊断乳腺癌的AUC为0.913；观察组CXCL1、Notch1、Gab2、FOXF1 mRNA表达量高于对照组，ATG2B、ATG4D mRNA表达量低于对照组（P<0.05）；乳腺癌患者动态增强MRI时间-信号强度曲线参数Ktrans、Kep、Vp、Max Cone、Max Slop、AUC与CXCL1、Notch1、Gab2、FOXF1 mRNA表达量呈正相关关系，与ATG2B、ATG4D mRNA表达量呈负相关关系（P<0.05）；TTP与CXCL1、Notch1、Gab2、FOXF1 mRNA表达量呈负相关关系，与ATG2B、ATG4D mRNA表达量呈正相关关系（P<0.05）。乳腺癌患者动态增强MRI时间-信号强度曲线参数变化与肿瘤细胞生物学行为密切相关。

关键词: 乳腺癌, 动态增强MRI, 时间-信号强度曲线, 肿瘤细胞生物学行为, 增殖基因, 侵袭基因, 自噬基因

Abstract: This study explored the correlation between the dynamic enhanced MRI time-signal intensity curve and the biological behavior of tumor cells in breast cancer patients. 60 patients with breast cancer were selected as the observation group, and 60 patients admitted to the same period with benign breast lesions were selected as the control group. All patients underwent dynamic enhanced MRI examination. The results showed that the maximum concentration of contrast agent (Max Cone), area under time-signal intensity curve (AUC), time-signal intensity curve maximum slope (Max Slop), rate constant (Kep), transport constant (Ktrans), plasma volume fraction (Vp) in the observation group were higher than those in the control group, while the time to peak (TTP) was lower than that in the control group (P<0.05). The AUC of Ktrans, Kep, Vp, TTP, Max Cone, Max Slop and (time-signal intensity curve) AUC in the combined diagnosis of breast cancer were 0.913. The mRNA expression levels of CXCL1, Notch1, Gab2 and FOXF1 in observation group were higher than those in the control group, while the expressions of ATG2B and ATG4D were lower than the control group (P<0.05). The dynamic contrast-enhanced MRI time-signal intensity curve parameters of Ktrans, Kep, Vp, Max Cone, Max Slop, AUC was positively correlated with the mRNA expression of CXCL1, Notch1, Gab2, FOXF1, while negatively correlated with ATG2B, ATG4D mRNA expression (P<0.05). TTP was negatively correlated with CXCL1, Notch1, Gab2, FOXF1 mRNA expression, and was positively correlated with ATG2B, ATG4D mRNA expression (P<0.05). The parameter changes of dynamic enhanced MRI time-signal intensity curve in breast cancer patients are closely related to the biological behavior of tumor cells.

Key words: breast cancer, dynamic contrast-enhanced MRI, time-signal intensity curve, biological behavior of tumor cells, proliferation genes, invasion genes, autophagy genes

叶东亮, 程世德, 范高洁, 郑晓梅. 乳腺癌患者动态增强MRI时间-信号强度曲线与肿瘤细胞生物学行为的相关性[J]. 影像科学与光化学, 2022, 40(5): 1088-1092.

YE Dongliang, CHENG Shide, FAN Gaojie, ZHENG Xiaomei. Correlation between the Dynamic Contrast-Enhanced MRI Time-signal Intensity Curve and the Biological Behavior of Tumor Cells in Breast Cancer Patients[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(5): 1088-1092.

参考文献

[1] Cuzick J, Sestak I, Forbes J F, et al. Use of anastrozole for breast cancer prevention (IBIS-II):Long-term results of a randomised controlled trial[J]. The Lancet, 2020, 395(10218):117-122.
[2] 易宗毕, 马飞, 荣国华, 等. 中国乳腺癌患者循环肿瘤DNA中TP53突变的临床特征及预后价值[J]. 癌症, 2021, 40(5):193-203.
[3] Saura C, Oliveira M, Feng Y H, et al. Neratinib plus capecitabine versus lapatinib plus capecitabine in her2-positive metastatic breast cancer previously treated with ≥ 2 HER2-directed regimens:Phase III NALA trial[J]. Journal of Clinical Oncology, 2020, 38(27):3138-3149.
[4] 孙瑞红, 王翔, 沈丽娟, 等. 乳腺癌患者MRI体素内不相干运动成像中感兴趣区选择方法对参数一致性的影响[J]. 中国癌症杂志, 2019, 29(9):700-708.
[5] Saadatmand S, Geuzinge H A, Rutgers E J T, et al. MRI versus mammography for breast cancer screening in women with familial risk (FaMRIsc):A multicentre, randomised, controlled trial[J]. The Lancet Oncology, 2019, 20(8):1136-1147.
[6] 唐竹晓, 徐丽娜, 孙召龙, 等. 磁共振成像动态增强联合DWI序列评估乳腺癌新辅助化疗中肿瘤组织变化应用可行性研究[J]. 中国CT和MRI杂志, 2022, 20(3):74-76.
[7] 李月梅, 仲维秀, 杨丽萍. MRI动态增强成像联合血清CA15-3 CEA对乳腺癌的诊断价值[J]. 河北医学, 2020, 26(2):218-221.
[8] 闫峰山, 周晶, 白岩, 等. 不同Ki-67表达状态乳腺癌患者临床和DCE-MRI特征[J]. 中国医学影像技术, 2019, 35(11):1657-1662.
[9] 付贝, 沈夏平, 马超, 等. 乳腺癌患者DCE-MRI各参数与MVD、VEGF的关系及其临床诊断价值[J]. 中国医学计算机成像杂志, 2019, 25(2):197-202.
[10] Robson M E, Tung N, Conte P, et al. OlympiAD final overall survival and tolerability results:Olaparib versus chemotherapy treatment of physician's choice in patients with a germline BRCA mutation and HER2-negative metastatic breast cancer[J]. Annals of Oncology, 2019, 30(4):558-566.
[11] Zhou Y, Fan Y J, Ma L, et al. Effect of toremifene on endometrium and neurocognitive function in patients with breast cancer based on resting-state functional magnetic resonance imaging[J]. World Neurosurgery, 2021, 149(7):436-443.
[12] Barth R J Jr, Krishnaswamy V, Paulsen K D, et al. A randomized prospective trial of supine MRI-guided versus wire-localized lumpectomy for breast cancer[J]. Annals of Surgical Oncology, 2019, 26(10):3099-3108.
[13] Golshan M, Wong S M, Loibl S, et al. Early assessment with magnetic resonance imaging for prediction of pathologic response to neoadjuvant chemotherapy in triple-negative breast cancer:Results from the phase III BrighTNess trial[J]. European Journal of Surgical Oncology, 2020, 46(2):223-228.
[14] 梁家宁. 动态对比增强MRI在良恶性乳腺肿瘤诊断中的研究[J]. 现代医用影像学, 2019, 28(5):961-963, 968.
[15] 左金, 闫海龙, 韩东明. DCE-MRI在卵巢交界性肿瘤与上皮性卵巢癌中的鉴别诊断价值[J]. 医学影像学杂志, 2020, 30(5):798-802.
[16] 孟洁, 李红雨, 赵书君, 等. CXCL1在子宫内膜样腺癌中的表达及其对Ishikawa细胞增殖侵袭的影响[J]. 暨南大学学报(自然科学与医学版), 2019, 40(6):508-517.
[17] 陈苹苹, 刘玉杰, 李威, 等. 四跨膜蛋白CD151调节结直肠癌Notch相关信号通路的研究[J]. 中国肿瘤, 2019, 28(1):69-73.
[18] Park Y R, Bae S H, Ji W, et al. GAB2 amplification in squamous cell lung cancer of non-smokers[J]. Journal of Korean Medical Science, 2017, 32(11):1784-1791.
[19] 钟圣鹏, 殷俊, 傅文凡, 等. 调控叉头盒转录基因F1表达对非小细胞肺癌细胞上皮间质转化、迁移和侵袭的作用[J]. 实用医学杂志, 2020, 36(14):1886-1891.
[20] 张雪梅, 李宏江, 王达, 等. 自噬相关基因ATG2B、ATG4D、ATG9B在浸润性乳腺癌中的表达及临床意义[J]. 四川大学学报(医学版), 2016, 47(2):184-188.
[21] Zhang X M, Li C, Wang D, et al. Aberrant methylation of ATG2B, ATG4D, ATG9A and ATG9B CpG island promoter is associated with decreased mRNA expression in sporadic breast carcinoma[J]. Gene, 2016, 590(2):285-292.