目的:探讨乳腺癌磁共振(MR)动态增强扫描的曲线最大增强线性斜率(SS)和组织微血管密度(MVD)的关系及二者的临床意义。方法:对58例原发性乳腺癌患者术前行动态增强MR扫描,根据时间-信号强度曲线计算出参数SS值,术后采用免疫组化方法检测乳腺癌组织中MVD情况,结合病理淋巴结转移情况加以分析。结果:38例淋巴结转移阳性组的MVD均数为52.75±13.87,SS均数为6.15±1.23(%/s),而阴性组的MVD和SS分别为38.23±11.45和2.48±1.12,二者相比均具有显著性差异(P值均〈0.05);且SS与MVD呈明显正相关关系(r=0.812,P〈0.05)。结论:MVD和SS均可作为判断乳腺癌淋巴结转移的预测因子和判断预后的指标,并且SS在术前能一定程度上反映乳腺癌的血管生成特征,较病理组织学方法更优越。
Objective:To investigate the relationship and clinical significance between steepest slope (SS) of dynamic contrast - enhanced magnetic resonance (MR) and histological microvessel density ( MVD ) in breast carcinoma. Methods: Total of 58 patients with breast carcinoma were underwent dynamic contrast - enhanced MR scanning before operation. The parameters SS and MVD were calculated based on time - signal intensity curves and immunohistochemical staining technique. The correlations of lymphatic involvement and SS as well as MVD were analyzed. Results: Tumors with axillary lymphatic involvement( n = 38) (MVD = 52.75 ± 13.87/HP; SS = 6.15 ± 1.23/%/ s)had significantly higher values of both SS and MVD than those without axillary lymphatic involvement(n = 20) ( MVD = 38.23 ± 11.45 /HP ; SS = 2.48 ±1.12/%/s) ( P 〈 0.05 ). Conclusion: SS and MVD had correlation with lymphatic involvement of breast carcinoma, and could be used to predict lymphatic involvement and prognosis. Especially, SS is more predominate than MVD in evaluating the microvessel conditions of breast carcinoma before oprations.