The Correlation Research Of Dynamic Contrast-enhanced MR And Diffusion Weighted Imaging With Histopathology And Molecular Biology In Breast Cancer

Objective:To study the correlation between MRI features and histopathology,molecular biology of breast cancer.Methods: eighty-five female with breast cancer were examined by MRI scanning, enhanced-scanning and DWI before the operations. The median age was 55 year (range 39-68 years). Using GE ADW 4.3workstation,DCE-MRI features were analyzed for tumor size,shape,edge,the relationship between lesions and surrounding tissues, enhancement pattern of mass,peak-time.DWI was done with single shot SE-EPI sequence,b=800s/mm2. The apparent diffusion coefficients (ADC) diagnostic was decions according to receiver operating characteristic curve (ROC).Histological specimens were made for tumor size,shape,edge,the relationship between lesions and surrounding tissues,histological grade,and expressions of ER,PR,CerbB-2 and Ki-67 in breast cancer were examined by immunohistochemisty method after operations. The pathologic and molecular biology data were compared with MRI features.The statistical analyses were performed with statistical software(SPSS for Microsoft Windows,version 13.0;SPSS),the statistical method used t and X2 test.Results There were 85 cases of breast cancer ,including 73 cases of infiltrating ductal carcinoma, 8 cases of infiltrating lobular carcinoma, 3 cases of ductal carcinoma and atypical medullary carcinoma in one;Of the 85 breast cancer lesions, there were 28 cases of homogeneous enhancement,27 cases of rim enhancement,and 30 cases of heterogeneous enhancement;The curve types were persistent in 12 lesions,plateau in 31 lesions,and washout in 42 lesions;A peak time occurring at the first postcontrast phase was seen for 52 cases,at the second postcontrast phase was seen for 33 cases; Of the 85 breast cancer lesions,73 cases were hyper-signal on DWI; ADC values in 62 cases less than 1.2x10-3mm2/s;There were 24 low-grade differentiated lesions,24 medium-grade differentiated lesions,37 high-grade differentiated lesions proved by pathology;Of the cases ,55.29%(47 of 85) were ER positive, 50.59%(43 of 85) were PR positive, 48.24%(41 of 85) were CerbB-2 positive, 51.76%(44 of 85) were Ki-67 positive.Of the 85 breast cancer lesions,there were 19 lesions made big slice by doctor,there were 5 oval shape,6 lobulated shape,and 8 irregular shape lesions. 89 reference points from 19 lesions edge. 68 points were doubted speculated.and the curve types were persistent in 20 lesions,plateau in 35 lesions,and washout in 34 lesions.There was significant relationship between MRI enhancing feature of breast cancer and shape of histopathology.benign and malignant breast lesions with there edge have high diagnosis and differ-ential diagnosis importance by DWI and ADC value.There was significant relationship between MRI enhancing feature of breast cancer and histological grade,peak time (p<0.05);There was significant relationship between MRI enhancing feature of breast cancer and its expression of CerbB-2 (p<0.05), and no significant relationship between MRI enhancing feature of breast cancer and its expressions of ER,PR and Ki-67(p>0.05). There was significant relationship between MRI edge feature of breast cancer and its expressions of ER,PR,C-erbB-2 (p<0.05). and no significant relationship between MRI edge feature of breast cancer and its expressions of Ki-67(p>0.05).Conclusion: The MR provides a direct and effective means to histopathology morphology in breast cancer.The sensitivity was higher to detect the breast lesions and higher to measure accurately by DCE-MRI.In evaluating the shape of breast lesions ,the diagnostic accuracy was highest.It was helpful for appreciating the grade differentiated of breast lesion to judge its shape and its enhancement mode.And it was also helpful for appreciating the biological behavior and prognosis of breast cancer through observing the enhancement mode.The shape of the time-signal intensity curve and ADC value are an important criterion in differentiating benign,malignant and their edge in breast MRI. It was useful to judge the expressions of ER, PR, C-erbB-2 and Ki-67 in breast cancer by observing its MRI imaging features;There exists some correlation among DCE-MRI morphologic features, histopathology and molecular biology factors in breast cancer to certain extent.The biologic behavior and prognosis of the breast cancer may be assessed according to MRI features.