中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2011年
12期
1113-1116
,共4页
郭丽%王霄英%秦乃珊%蒋学祥
郭麗%王霄英%秦迺珊%蔣學祥
곽려%왕소영%진내산%장학상
乳腺肿瘤%磁共振成像%对比研究
乳腺腫瘤%磁共振成像%對比研究
유선종류%자공진성상%대비연구
Breast neoplasms%Magnetic resonance imaging%Comparative study
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.
目的 探討乳腺癌患者新輔助化療前後ADC值和癌竈最大徑與Ki-67不同錶達程度之間的關繫.方法 迴顧性分析48例穿刺活檢證實為乳腺癌的患者資料,患者于新輔助化疔前及化療第4週期後行MR DWI及增彊掃描.測量化療前後癌竈的ADC值及最大徑,併計算其變化率△ADC％和△D％.利用Ki-67指數不同,將所有癌竈分為A、B、C三組:A組Ki-67＜ 20％,B組Ki-67為20％ ～ 60％,C組Ki-67＞ 60％.採用非參數檢驗比較3組癌竈化療前後ADC值、△ADC％、最大徑及△D％的差異.結果 化療前A組(15例)癌竈的ADC值為1.1 × 10-3 mm2/s[(0.9×10-3～1.2×10-3)mm2/s],高于B組[8例,0.9×10-3 mm2/s(0.9×10-3～1.0×10-3) mm2/s]和C組[25例,0.9×10-3mm2/s(0.7 × 10-3～1.2×10-3)mm2/s],差異有統計學意義(P＜0.05)；而化療後C組癌竈的ADC值為1.3×10-3 mm2/s[(0.2×10-3 ～ 1.4×10-3)mm2/s],高于A組[1.1×10-3 mm2/s,(1.0× 10-3 ～ 1.2×10-3)mm2/s]和B組[1.1×10-3 mm2/s(1.0×10-3～1.1×10-3)mm2/s],差異具有統計學意義(P＜0.01)；化療前後C組癌竈的ADC變化率為45.5％(- 12.0％～78.6％),大于A組[45.5％(- 12.0％ ～ 78.6％)]和B組[45.5％(- 12.0％～78.6％)],差異具有統計學意義(P＜0.01).化療前、後癌竈的最大徑A組分彆為2.2 cm(2.0～2.4 cm)和1.0 cm(0.0～ 1.4 cm),均小于B組[化療前3.7 cm(3.6～3.9 cm),化療後2.9 cm(0.0 ～3.1 cm)]和C組[化療前3.4 cm(2.7 ～4.2 cm),化療後1.9 cm(0.0 ～2.2 cm)],且差異具有統計學意義(P＜0.05)；B組癌竈化療後最大徑的變化率為21.6％(- 15.2％ ～ 27.5％),小于A組[52.7％(-23.6％ ～72.1％)](P＜0.01)和C組[51.2％(- 10.3％～92.6％)](P＜0.05),差異具有統計學意義.結論 對于Ki-67指數不同錶達程度的癌竈,新輔助化療前、後癌竈的ADC值不同,癌竈的ADC值及最大徑線對于化療的反應不同,差異具有統計學意義.
목적 탐토유선암환자신보조화료전후ADC치화암조최대경여Ki-67불동표체정도지간적관계.방법 회고성분석48례천자활검증실위유선암적환자자료,환자우신보조화정전급화료제4주기후행MR DWI급증강소묘.측양화료전후암조적ADC치급최대경,병계산기변화솔△ADC％화△D％.이용Ki-67지수불동,장소유암조분위A、B、C삼조:A조Ki-67＜ 20％,B조Ki-67위20％ ～ 60％,C조Ki-67＞ 60％.채용비삼수검험비교3조암조화료전후ADC치、△ADC％、최대경급△D％적차이.결과 화료전A조(15례)암조적ADC치위1.1 × 10-3 mm2/s[(0.9×10-3～1.2×10-3)mm2/s],고우B조[8례,0.9×10-3 mm2/s(0.9×10-3～1.0×10-3) mm2/s]화C조[25례,0.9×10-3mm2/s(0.7 × 10-3～1.2×10-3)mm2/s],차이유통계학의의(P＜0.05)；이화료후C조암조적ADC치위1.3×10-3 mm2/s[(0.2×10-3 ～ 1.4×10-3)mm2/s],고우A조[1.1×10-3 mm2/s,(1.0× 10-3 ～ 1.2×10-3)mm2/s]화B조[1.1×10-3 mm2/s(1.0×10-3～1.1×10-3)mm2/s],차이구유통계학의의(P＜0.01)；화료전후C조암조적ADC변화솔위45.5％(- 12.0％～78.6％),대우A조[45.5％(- 12.0％ ～ 78.6％)]화B조[45.5％(- 12.0％～78.6％)],차이구유통계학의의(P＜0.01).화료전、후암조적최대경A조분별위2.2 cm(2.0～2.4 cm)화1.0 cm(0.0～ 1.4 cm),균소우B조[화료전3.7 cm(3.6～3.9 cm),화료후2.9 cm(0.0 ～3.1 cm)]화C조[화료전3.4 cm(2.7 ～4.2 cm),화료후1.9 cm(0.0 ～2.2 cm)],차차이구유통계학의의(P＜0.05)；B조암조화료후최대경적변화솔위21.6％(- 15.2％ ～ 27.5％),소우A조[52.7％(-23.6％ ～72.1％)](P＜0.01)화C조[51.2％(- 10.3％～92.6％)](P＜0.05),차이구유통계학의의.결론 대우Ki-67지수불동표체정도적암조,신보조화료전、후암조적ADC치불동,암조적ADC치급최대경선대우화료적반응불동,차이구유통계학의의.
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.
