Estrogen receptor and breast MR imaging features: A correlation study
Estrogen receptor and breast MR imaging features: A correlation study
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DOI：
10.1002/jmri.21330
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发表时间：
2008-04-01
影响因子：
4.4
通讯作者：
Su, Min-Ying
中科院分区：
文献类型：
--
作者：
Chen, Jeon-Hor;Baek, Hyeon-Man;Su, Min-Ying
目的：为比较雌激素受体（ER）阳性与阴性乳腺癌的MRI表现，材料与方法：对90例经临床证实的浸润性导管癌（IDC）患者的MRI表现进行分析，其中ER阳性51例，ER阴性39例。根据美国放射学会（ACR）乳腺成像报告和数据系统（BI-RADS）MRI词典评价肿瘤形态和动态对比增强（DCE）动力学并进行比较。对MRI上的腋窝淋巴结肿大和使用MR波谱（MRS）进行的胆碱（Cho）检测进行了分析和比较。结果：ER阴性乳腺癌的肿瘤体积大于ER阳性乳腺癌（3.6 ± 2.0 cm vs.1.8 ± 1.3 cm，P < 0.00005）。与ER阳性癌相比，ER阴性癌更可能表现出非肿块型增强（P < 0.005）。ER阴性组腋窝淋巴结肿大率高于ER阳性组（P < 0.05）。排除接受新辅助化疗的患者后，ER阳性和ER阴性癌症的腋窝淋巴结状态在MRI和病理学上没有显着差异。ER阴性癌更易表现为恶性型增强动力学（P = 0.15），边缘增强（P = 0.15），和Cho检测MRS与ER阳性癌相比，差异有统计学意义（P = 0.23），但未达到统计学显著水平。ER阴性乳腺癌更具侵袭性，肿瘤体积更大，非肿块型增强病变更多，MRI显示腋窝淋巴结肿大的百分比更高。这些特征可能与其较差的细胞分化和/或较高的血管生成有关。
Purpose: To compare the MRI features between estrogen receptor (ER) positive and negative breast cancers.Materials and Methods: Breast MRI of 90 consecutive patients confirmed with invasive ductal carcinoma (IDC), 51 ER positive and 39 ER negative, were analyzed. The tumor morphology and dynamic contrast-enhanced (DCE) kinetics were evaluated based on the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon and compared. Enlarged axillary lymph nodes on MRI and choline (Cho) detection using MR spectroscopy (MRS) were also analyzed and compared. For patients receiving axillary node dissection the pathological nodal status was also compared.Results: ER negative breast cancer had bigger tumors compared to ER positive cancer (3.6 +/- 2.0 cm vs. 1.8 +/- 1.3 cm, P < 0.00005). ER negative cancer was more likely to exhibit nonmass type enhancements compared to ER positive cancer (P < 0.005). Enlarged axillary lymph nodes were more frequently identified on MRI in ER negative compared to ER positive patients (P < 0.05). After excluding patients undergoing neoadjuvant chemotherapy, axiliary lymph node status did not show significant difference between ER positive and ER negative cancer on MRI and pathology. ER negative cancer was more likely to show the malignant type enhancement kinetics (P = 0.15), rim enhancement (P = 0.15), and Cho detection on MRS (P = 0.23) compared to ER positive cancer, but it did not reach a level of statistical significance.Conclusion: ER negative breast cancer was more aggressive, with larger tumor size, more non-mass-type enhancement lesions, and a higher percentage showing enlarged axillary nodes on MRI. These features might be related to its poorer cellular differentiation and/or a higher angiogenesis.