DCE-MRI Quantitative Parameter Identification Of Benign And Malignant Breast Lesions And Relevance To Molecular Subtypes Of Breast Cancer Research

The first part DCE MRI quantitative parameter identification of benign and malignant breast lesionsObjective: through the mammary gland(DCE)MRI dynamic enhancement scanning measuring quantitative parameters of breast lesions(Ktrans,Kep,Ve)value,combined with the pathological results to study the diagnosis value of quantitative parameters.Methods: collected in November 2016 to February 2018 through other inspection method failed to diagnose patients,92 cases of breast lesions,line DCE-all without any treatment before MRI.Using OK software measuring quantitative parameters(Ktrans,Kep,Ve)values.Then individualization preoperative biopsy or surgical treatment,pathological results and imaging examination,and finally obtain corresponding quantitative parameters such as data of the statistical analysis,P<0.05,with statistical significance.Results: The breast malignant and benign lesions and normal gland group in Ktrans values were 0.677 ±0.212,0.359,0.029 0.013 mm,0.129 mm Kep values were 1.437 ±0.529,0.699,0.184 0.082 mm,0.279 mm Ve values were 0.511,0.527 ±0.149,0.149 0.166 mm ±0.136.Ktrans and Kep are differences among the three groups(P < 0.05),Ve there are differences between normal glands and lesion group(P < 0.05),no difference between benign and malignant groups(P > 0.05).Combined with the quantitative parameter values and DCE-magnetic resonance imaging(MRI)in patients with pathologic results ROC curve drawing,quantitative parameter value Ktrans,Kep,Ve area under the curve of the corresponding were 0.882,0.810,0.463;According to the largest Youden index,to set the mammary gland malignant lesions Ktrans boundary value is 0.651,specificity and sensitivity were 0.883,0.891;To set the Kep boundary value is 0.651,specificity and sensitivity of 0.800,0.776,respectively.Conclusion: Ktrans,Kep has high diagnostic value,at the same time,the two parameters identification of benign and malignant lesions have some clinical reference value,the quantitative parameter value Ktrans diagnosis efficiency is preferred.Quantitative parameter value has a certain value of Ve,but there is no sense(in)for differentiating benign and malignant.DCE-MRI is the conven tional MRI has more advantages.The second part MRI quantitative parameters and the research of breast cancer molecular subtypesObjective: DCE-MRI quantitative parameter(Ktrans,Kep,Ve)the correlation between prognostic factors of breast cancer and molecular subtypes and comp arison,and then determine whether the DCE MRI quantitative parameter can predict prognostic factors and molecular subtypes of breast cancer.Methods: collected in November 2016-February 2018,69 cases of breast cancer patients,which was confirmed by postoperative pathological data.All patients with preoperative DCE-MRI examination and quantitative parameters of measuring Ktrans,Kep,Ve,postoperative samples were given pathological dete ction and SP method of immunohistochemical detection.Detection of four kinds of immunohistochemical index the expression of ER and PR,and HER2 and Ki67 state,give again for HER2(+ +)immune fluorescence in situ hybridizati on(FISH)to detect.Combination of the above four kinds of receptor expression,further divided into Luminal A type,Luminal B type,its ehrs-2 expression type and three negative four molecular subtypes.The corresponding statistical methods were analyzed,and the selection to P < 0.05 for statistical significance.Results: the patients with ER and PR negative Ktrans and Kep values were 0.679,1.461 0.471 mm,0.296 mm is higher than that in patients with ER and PR positive Ktrans and Kep value,0.568±0.312,0.312±0.592,respectively,the difference was statistically significant(P < 0.05).Its ehrs-2 of the positive and negative patients with different degree of expression and Ki-67,the quantitative parameters measured by difference had no statistical significance(P > 0.05).A quantitative parameter values in four different molecular subtypes of breast cancer each differences had no statistical significance(P > 0.05).Conclusion: ER and PR receptors in breast tumors with Ktrans,Kep value has a certain relationship,but important prognostic factors of its ehrs-2 and Ki-67 no obvious correlation with the quantitative parameters.And to differentiate different molecular subtypes of breast cancer,found no evidence to prove that the DCE-quantitative parameters have clear reliability of MRI.