| Objective:This study aimed to predict the expression of pathological prognostic factors in breast cancer by investigating the correlation between quantitative dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI),diffusion kurtosis imaging(DKI),diffusion weighted imaging(DWI),and other related parameters with NPI,Ki-67 expression,CK5/6,and P53.The objective is to predict the expression of pathological prognostic factors from the perspective of imaging,so as to provide relevant basis for individual selection of clinical treatment and prognostic monitoring of breast cancer.This study is a retrospective study that screened54 patients with postoperative pathological diagnosis of invasive breast cancer from November 2021 to January 2023.All these patients underwent quantitative DCE-MRI,DKI,and DWI scans in our hospital before further treatment.Two radiologists collected the images and independently evaluated them,measuring the apparent diffusion coefficient(ADC)of magnetic resonance,the volume transfer constant(Ktrans),rate constant(Kep),and extravascular-extracellular volume fraction(Ve)of quantitative DCE-MRI,as well as the mean kurtosis(MK)and mean diffusivity(MD)of the DKI model.Spearman correlation analysis was applied to explore the correlation between the above variables and the Nottingham Prognostic Index(NPI),Ki-67 expression status,CK5/6,and P53.Subsequently,binary logistic regression analysis and receiver operating characteristic(ROC)curve analysis were used to analyze their diagnostic value for predicting NPI and Ki-67 expression status.Methods:This study is a retrospective study that selected 54 patients with pathologically confirmed breast cancer after surgery between November 2021 and January 2023.All patients underwent quantitative DCE-MRI,DKI,and DWI scans at our hospital before further treatment.Two radiologists collected the images and evaluated them separately,measuring the apparent diffusion coefficient(ADC)of DWI,the volume transfer constant(Ktrans),rate constant(Kep),and the extravascular-extracellular volume fraction(Ve)of quantitative DCE-MRI,as well as the mean kurtosis(MK)and mean diffusivity(MD)of DKI.Independent samples t-tests or Mann-Whitney U tests were used to compare the differences in various parameters between different groups of NPI,Ki-67 expression,CK5/6,and P53.Spearman correlation analysis was applied to investigate the correlation between these parameters and various prognostic factors.Binary logistic regression analysis and receiver operating characteristic(ROC)curve analysis were used to evaluate the diagnostic value of these parameters for predicting the NPI and Ki-67 expression statusResults:According to our research results,there were no significant differences in ADC values among different groups classified by NPI,Ki-67 expression,CK5/6,and P53 in breast cancer.Meanwhile,we found that Ktrans and Kep values differed significantly among different groups classified by Ki-67 expression(P<0.05),with higher expression groups having higher Ktrans and Kep values,which were positively correlated with Ki-67 expression.Moreover,when judging Ki-67 expression,Ktrans value had a higher diagnostic value than Kep value(P<0.01).Combining Ktrans and Kep could more accurately distinguish high and low Ki-67 expression.In high-grade NPI group(NPI≥3.4)and low-grade NPI group(NPI<3.4),we found that MK,Ktrans,and Kep values were significantly higher in the high-grade NPI group than in the low-grade NPI group(P<0.05).Additionally,MK,Ktrans,and Kep values were correlated with NPI to a certain extent.Regarding predicting NPI,Kep had a larger area under the ROC curve(AUC)than Ktrans and MK;furthermore,the combined index Ktrans+Kep had a slight advantage over single parameters.There were no significant differences in various parameters between Luminal and non-Luminal subtypes of breast cancer.Kep had significant differences among different groups classified by CK5/6(P<0.05),while only Ktrans differed among different groups classified by P53(P<0.05).NPI index showed significant differences among groups classified by Ki-67 and CK5/6 expression status(P<0.05),and there was a correlation between NPI index and Ki-67 expression status(R=0.373,P=0.008)and a moderate correlation with CK5/6 status(R=0.493,P<0.001),indicating that NPI index may be related to tumor proliferation activity and basal cell status. |
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