The Correlation Between The MRI Performance Of Breast Cancer And Biological Facrors ER,PR, C-erbB-2,p53

Background and purposeBreast cancer is the most common malignancy of women, In 2002, the cases of breast cancer is issued 1.15 million in the global, ranking No.2 cancer, death rate ranks No.5. compared with the United States and Europe, China, despite lower incidence of breast cancer,-in recent years, with the changes of fertility patterns and lifestyle, the incidence of breast cancer showed an upward trend year by year, and getting younger, The breast cancer has increased the first tumor for women, The breast cancer seriously endangers the health and lives of women, Therefore, the right diagnosis, proper treatment, the accurate prognosis of breast cancer is great significant.At present, the research of breast cancer is from the morphological to the molecular level gradually deepened. In the course of exploration of breast cancer molecular biological mechanism to in-depth study, a'number of biological factors which closely related the breast cancer has been found, Such as the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (c-erbB-2), tumor suppressor gene p53and so on. These biological factors play an important role in determining the biological behavior and the occurrence, development of the breast cancer through the micro-mechanism and an important indicator to evaluate the biological behavior, treatment options, and prognosis of breast cancer.MRI accounts for an important position in the diagnosis and evaluation of breast cancer. Especially high-field MRI, the superior soft tissue resolution and rich examination of means:dynamic contrast-enhanced magnetic resonance scanning (DCE-MRI), diffusion-weighted imaging (DWI), perfusion Imaging (PWI), proton magnetic resonance spectroscopy (1H-MRS), could be a very good understanding of breast cancer's morphological and hemodynamic characteristics, changes in chemical and biological substances, the functional status of organization, so it is possible and realistic to detect the disease characteristics with MRI at the cellular and molecular level.The most common, direct and accurate method to obtain the biological factors' expression status of breast cancer depend on the immunohistochemical staining of surgical removal tissue, yet the means is invasive and postoperative. It has important clinical significance to explore the correlation between MRI features of breast cancer and the biological factors by non-invasive means to predict the expression of these biological factors.. The purpose of this study is to explore the correlation between MRI characteristics and biological factors of ER, PR, c-erbB-2, p53 through a group cases of breast cancer.Materials and methods39 cases of breast cancer collected during the period February 2009 to February 2010, all cases'MRI examination were performed in the line of First Affiliated Hospital of Zhengzhou University, and confirmed by surgery and pathology,39 lesions'MRI characteristics and immunohistochemical results were analyzed. All patients were female, age range 29 to 72, with an average age of 45.4 years, MRI examination within 1 week before surgery carried out, using the Siemens Magnetom Trio Tim 3.0T MRI device and a proprietary phase array breast surface coils. Followed by T1-weighted imaging (T1WI), inversion recovery T2-weighted images (T2WI), diffusion-weighted imaging (DWI), dynamic contrast-enhanced and delayed scans. All images are in Syngo workstation dealt with by two experienced physicians (at least one deputy director of the physician) independent of the 39 cases of breast cancer patients to conduct a detailed analysis of image data, respectively, recorded rim enhancement, speculate, the type of time-intensity curve(TIC), the early-phase enhancement ratio(EPER), peak to time, apparent diffusion coefficient (ADC) value and other indicators.Collecting the pathological results of inmmunohistochemistry and the expression of biological factors ER,PR,c-erbB-2,p53,The correlation between magnetic resonance image features and biological factors were analyzed with statistical software SPSS1.3.0.ResultsAll the 39 cases of breast cancer, infiltrating ductal carcinoma 35 cases, ductal carcinoma in situ 1 case, lobular carcinoma 2 cases, mucinous adenocarcinoma 1 case, Axillary lymph node metastasis 4 cases, lung metastasis 1 case, multiple bone metastasis 1 case.MRI features:39 lesions,22 showed rim enhancement of the total cases 56.4%; 26 cases of the performance speculate, accounting for 66.7% of the total cases; flow-out curve 21 cases, accounting for 53.8%, flat curve in 11 cases, accounted for 28.2%, single-phase curve 7 cases, accounting for 17.9%; the maximum early-phase enhancement rate at 1 minute 279.7%, the minimum early-phase enhancement rate 40.0%, the average enhancement ratio 141.4±62.6%; the lesions fastest to the 70s, the maximum time to the peak 350s, the average peak to time 142±70s; the maximum ADC value 2.184×10-3mm2/s, the minimum ADC value 0.630×10-3mm2/s, the average ADC value 0.9662±0.2773×10-3mm2/s.Immunohistochemical results:39 cases, ER positive expression 24 cases, positive expression rate 61.5%; PR positive expression 16 cases, positive expression rate 41.0%; c-erbB-2 positive expression 17 cases, positive expression rate 43.6%; p53 positive expression cases 14 patients with positive expression rate of 35.9%.Statistical results:speculate with ER positive was positively correlated; peak to time with p53 positive was negatively correlated; ADC value the negative correlation with P53 positive. Rim enhanced PR negative rate was higher than PR positive; c-erbB-2 positive cases early enhancement rate than the average rate of c-erbB-2 negative cases; c-erbB-2 positive is less than the average peak to time of cases c-erbB-2 negative; the ADC value of ERnegative and c-erbB-2 positive cases averaged less than ER positive and c-erbB-2 negative casesConclusionThere are certain correlation between MRI characteristics and biological factors of breast cancer ER, PR, c-erbB-2, p53, It is possible to evaluate the biological factors'expression status of ER, PR, c-erbB-2, p53 according to MRI performance.