Parameters of dynamic contrast-enhanced MRI as imaging markers for angiogenesis and proliferation in human breast cancer.
Parameters of dynamic contrast-enhanced MRI as imaging markers for angiogenesis and proliferation in human breast cancer.
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动态对比增强 MRI 参数作为人类乳腺癌血管生成和增殖的成像标志物。
DOI：
10.12659/msm.892534
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发表时间：
2015-02-01
期刊：
影响因子：
--
通讯作者：
Shen B
中科院分区：
文献类型：
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作者：
Li L;Wang K;Sun X;Wang K;Sun Y;Zhang G;Shen B
乳腺癌是世界范围内最常见的恶性肿瘤，也是女性癌症死亡的主要原因;然而，由于其复杂的病理结构，早期诊断一直很困难。本研究评估形态学检查结合动态增强MRI（DCE-MRI）对乳腺癌更精确诊断的价值，以及它们与血管生成和增殖生物标志物的相关性。获取124例乳腺癌患者（124个病灶）的DCE-MRI参数（包括Ktrans：反映血管渗透性的体积传递系数、Kep：通量速率常数、Ve：反映血管渗透性的细胞外体积比、ADC：表观扩散系数）。通过免疫组化分析肿瘤血管的CD 31和CD 105表达来评估微血管密度（MVD）。通过分析Ki 67来评估增殖。Ktrans值大小依次为：恶性病变>良性病变>正常腺体。对于Kep观察到类似的结果。Ve的变化与此相反。浸润性导管癌（IDC）和导管原位癌（DCIS）中的Ktranss和Kep值显著高于乳腺导管发育不良（MDD; ANOVA，然后进行Dunnett检验）。IDC和DCIS的ADC值明显低于MDD，而Ve在三组间无显著性差异。最大密度投影（MIP）显示乳腺良性病变无或仅有一条血管，而恶性病变有两条或多条血管。此外，CD 105和Ki 67的表达，血管生成和增殖，分别是公认的标志物，与MRI参数密切相关的皮尔逊分析。Ktranss、Kep和ADC值的测定允许估计乳腺癌中的肿瘤血管生成和增殖，并且DCE-MRI参数可用作成像生物标志物以预测患者预后和肿瘤的生物侵袭性。
Breast cancer is the most common malignancy and the leading cause of cancer death in women worldwide; however, early diagnosis has been difficult due to its complex pathological structure. This study evaluated the value of morphological examination in conjunction with dynamic contrast-enhanced MRI (DCE-MRI) for more precise diagnosis of breast cancer, as well as their correlation with angiogenesis and proliferation biomarkers. DCE-MRI parameters (including Ktrans: volume transfer coefficient reflecting vascular permeability, Kep: flux rate constant, Ve: extracellular volume ratio reflecting vascular permeability, and ADC: apparent diffusion coefficient) were obtained from 124 patients with breast cancer (124 lesions). Microvessel density (MVD) was evaluated by the immunohistochemical analysis of tumor vessels for CD31 and CD105 expression. The proliferation was assessed by analyzing Ki67. Ktrans values were in the order of: malignant lesions > benign lesions > normal glands. Similar results were observed for Kep. The opposite changes were seen with Ve. Ktrans and Kep values were significantly higher in invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS) than in mammary ductal dysplasia (MDD; ANOVA followed by Dunnett’s test). In sharp contrast, ADC values were lower in IDC and DCIS than in MDD, and Ve was not significantly different among the three groups. The data from MIP (maximum intensity projection) showed that benign breast lesions had no or only one blood vessel, whereas malignant lesions had two or more blood vessels. In addition, expression of CD105 and Ki67, the commonly recognized markers for angiogenesis and proliferation, respectively, were closely correlated with MRI parameters as revealed by Pearson analysis. Determination of Ktrans, Kep and ADC values permits estimation of tumor angiogenesis and proliferation in breast cancer and DCE-MRI parameters can be used as imaging biomarkers to predict patient prognosis and the biologic aggressiveness of the tumor.