A Comparative Study Of MRI Features,Histopathology And Immunohistochemistry Of Breast Mucinous Carcinoma

Objective:Through the contrast analysis of MRI imaging features,histopathological features and the expression of biomarkers related to immunohistochemistry of breast mucinous carcinoma,the non-invasive classification diagnosis of preoperative MRI of breast mucinous carcinoma can be realized,and at the same time,more imaging basis can be provided for the development of clinical adjuvant therapy and personalized plan.Materials and methods:1.Retrospective analysis was performed on 37 cases of breast mucinous carcinomas diagnosed by surgery and pathology in our hospital from January 2018 to July 2020,including 25 cases of pure type and 12 cases of mixed type.The age ranges from 27 to 83 years,and the middle age is 47 years.All MRI examinations were completed within 1 week before operation.2.The MRI parameters were collected: tumor size,shape,edge,T1 WI signal,T2 WI signal,DWI signal and ADC value,early enhancement characteristics,TIC type,lymph nodes,etc.Chi-square test or Fisher’s exact probability method was used to distinguish the differences in morphology,margin,T1 WI signal,T2 WI signal,DWI signal,characteristics of early enhancement,TIC type and lymph node between simple and mixed breast mucocarcinoma.T test was used to distinguish the differences in tumor size and ADC value between the two types.The differences were statistically significant(P < 0.05).3.The pathological parameters were collected: the proportion of mucus in breast mucinous carcinoma,the proportion of other invasive carcinoma components and their distribution.Spearman rank test was used to analyze the correlation between the proportion of mucus in breast mucinous carcinoma,the proportion of other invasive carcinoma components and ADC value.The expressions of ER,PR,HER-2 and Ki67 were collected,and the differences between the pure type and the mixed type were differentiated by Mann-Whitney U rank sum test.The differences were statistically significant(P < 0.05).4.Finally,Spearman rank test was used to analyze the correlation between MRI indexes and PR,HER-2 and Ki67 indexes of breast mucinous carcinoma,and the difference was statistically significant,P < 0.05.Results:1.Of the 37 cases,33 were mass types and 4 were non-mass types(3 were pure types and 1 was mixed type).Morphological features of breast mucinous carcinoma were mainly regular(22 cases,59.5%)and no burr(26 cases,70.3%).Signal characteristics present T1 WI low signal(24 cases,64.9%),T2 WI show high signal(35 cases,94.6%),uneven reinforcement(20 cases,54.1%),time signal intensity curve Ⅰ type and Ⅱ(total 33 cases,89.2%),high ADC values((1.70 + 0.32)x10-3 was/s).2.Pure type and Mixed type groups had 25 cases and 12 cases respectively,and there were significant differences in morphology,margin,T2 WI lipid suppressive signal,TIC type,tumor maximum diameter,ADC value and lymph node status(P <0.05).There were no significant differences in T1 WI signal and enhancement characteristics(P > 0.05).3.The ADC value of breast mucinous carcinoma was positively correlated with the proportion of mucinous carcinoma(r = 0.975,P = 0.005,P < 0.05),and negatively correlated with the proportion of other invasive carcinoma(r =-0.975,P = 0.005,P <0.05).4.There was statistically significant difference in the expression of Ki67 index between pure and mixed breast mucinous carcinoma(Z =-2.252,P < 0.05),but there was no significant difference in the positive expression of ER,PR and HER-2between the two types(P < 0.05).The positive expression rates of ER and PR were both high,and the positive expression rates of HER-2 were low,including 1 case of pure type and 2 cases of mixed type,but the positive expression rate of Ki67 index of pure type was lower than that of mixed type(16% vs 50%).5.The lymph node metastasis of mucinous carcinoma was negatively correlated with PR expression(r =-0.369,P < 0.05).High T2 WI signal(r = 0.534,p < 0.05),TICⅠ or Ⅱ type(r = 0.439,p < 0.05),the ADC values(r = 0.416,p < 0.05)was negatively correlated with the expression of HER-2;High T2 WI signal was negatively correlated with Ki67 status(r =-0.457,P < 0.05),the positive expression rate of Ki67 index was positively correlated with axillary lymph nodes(r = 0.356,P < 0.05).Conclusion:1.MRI examination can distinguish between pure type and mixed type mucinous carcinoma before operation,which can provide help for clinical diagnosis and surgical method selection.2.The prognosis of mucinous carcinoma of breast is generally good,and and the prognosis of pure type is better than that of mixed type.3.Through the non-invasive MRI method,we can indirectly infer the immunohi-stochemical index of breast mucinous carcinoma,provide help for clinical diagnosis,adjuvant treatment,and even predict its prognosis.