Correlation Between MRI Imaging Feature And Biological Factors And Molecular Type And Histological Grade In Breast Cancer

OBJECTIVE: To investigate the correlation between magnetic resonance imaging features and molecular biology index,molecular subtype and WHO histological grade of breast cancer.MATERIALS AND METHODS: This study retrospectively analyzed a total of 90 patients with breast cancer from March 2015 to February 2017 at the Second Affiliated Hospital of Guangzhou Medical University through puncture or surgical pathology.All patients were unilateral breast disease,which including 75 cases of single mass,15 cases of multiple masses,the age range of 29 to 87 years old,the average age of 54 years.All patients didn’t underwent any related treatment before surgery and were successfully performed before the dynamic monitoring of breast magnetic resonance imaging(DCE-MRI),postoperative pathological sections and immunohistochemical examination.All imaging-related parameters were determined by two radiologists attending physicians with more than five years of clinical experience based on the MRI breast imaging report and data system(BI-RADS).The image included morphological features of the tumor: the diamater of the mass(>2cm or≤2cm),tumor shape(round,lobulated,irregular),The edge of the mass(smooth,burr,not smooth),the contrast enhanced type of the mass(homogeneous,heterogeneous,ring),Hemodynamics characteristics: time-signal intensity curve(TIC),including,type I: slow rise;II: early rapid rise,while in the late speed remained at a steady level;III type: After contrast injection,the lesion can be significantly enhanced early,while the signal intensity in the late lesions was gradually decreased;tumor signal enhancement rate,peak time,washout rate and other indicators.The pathological data of the patients were analyzed and recorded,including tumor lymph node metastasis and WHO classification.The expression of biological factors and molecular subtypes wereobtained by immunohistochemistry,including estrogen receptor(ER),Progesterone receptor(PR),proto-oncogene human epidermal growth factor receptor-2(C-erbB-2),tumor suppressor gene P53,cell proliferation antigen marker(Ki-67),TopoⅡα isoenzyme and so on.Data analysis,the application of SPSS 22.0 software,measurement data to take the mean ± standard deviation(x ± s)expression,line nonparametric Spearman correlation test and binary logistic regression analysis,test significance to α = 0.05 for the standard,P<0.05 was considered to be statistically different.Results :Seventy-five cases(83%)with multiple mass and 15(17%)with multiple masses,round lesion of 33 cases(37%),29 cases(32%)of lobes,28 cases of irregular31%);31 cases(34%)with smooth margins,20 cases(22%)were not on the edge,39 cases(43%)of burr edge,the enhancement type of tumor,48 cases(53%)with homogeneous,about 29 cases(32%)of heterogeneous enhancement,13 cases(14%)of ring enhancement.Time-signal curve type: type Ⅱ 47 cases(52.2%),type Ⅲ 43cases(47.8%),The maximum enhancement rate was 93.5% ~ 494.53%,the average value was(271.92 ± 62.30)%.(89.6%),The peak time of the lesion was 58.21 ~ 414.89 s,the mean peak time was(196.69 ± 100.28)s,pathological and immunohistochemical results:80 cases of invasive ductal carcinoma of the breast(89.0%),1 case of breast mucinous adenocarcinoma(1.1%),3 cases of advanced breast ductal carcinoma(3.3%),breast invasive lobular carcinoma in 4 cases(4.4%),breast invasive papillary carcinoma in 2cases(2.2%).There were 35 cases(48.9%)with lymph node metastasis and 55 cases(61.1%)with negative lymph node metastasis.ER positive expression in 58 cases(64.4%),ER negative expression in 32 cases(35.6%),PR positive expression in 45 cases(50%),PR negative expression in 45 cases(50%),C-erbB-2 positive expression in 29 cases(48.3%),C-erbB-2 negative expression in 61 cases(51.7%),p53 positive expression in 22 cases(24.4%),p53 negative expression in 68 cases(75.6%),TopoⅡα negative expression in 31cases(34.5%),TopoⅡα positive expression in 59 cases(55.5%),Ki-67 positive expression67(74.4%),Ki-67 negative expression in 23 cases(25.6%).(1)The size of the tumor was negatively correlated with the expression of ER(r =-0.264,p = 0.012),p53(r = 0.22,p = 0.03)and the expression of C-erbB-2(r = 0.272,p = 0.032)was positively correlated.(2)The morphology of the tumor was negatively correlated with the expression of ER(r =-0.273,p = 0.009)and PR(r =-0.226,p = 0.032),but positively correlated with the expression of C-erbB-2(r = 0.220,p = 0.037).(3)The marginal edge of the tumor was positively correlated with the ER(r = 0.320,p =0.002)and PR(r = 0.209,p = 0.048).(4)There was no significant correlation between the tumor enhancement pattern and the enhancement curve type and the biological factors.(5)Lymph node metastasis was positively correlated with P53(r = 0.275,p = 0.014)and Ki-67(r = 0.237,p = 0.026).(6)There was a negative correlation between peak time and TopoⅡα expression(r =-0.240,p = 0.04)and Ki-67 expression(r =-0.296,p = 0.01),but there was no significant difference in signal enhancement rate and washout rate with biological factors.(7)There was a significant positive correlation between molecular typing and tumor size(r= 0.239,p = 0.041),the diameter of Her-2 overexpressing breast tumors was larger than other types of tumors.(8)The WHO grade of breast cancer was significantly negatively correlated with the enhancement pattern in the tumor(r=-0.235,p=0.043),that is,the higher the histological grade of the tumor,the tumor enhancement tend to be heterogeneous.(9)Logistic regression analysis indicated that HER-2 positive expression of the mass for the larger diameter risk is HER-2 expression of negative 5.71 times,P53 positive expression of the larger diameter of the risk of P53 expression was negative of 5.403 times,The risk of large diameter of TopoⅡα expression was 3.565 times higher than of those with negative P53 expression.Conclusion: This study suggests that there are some correlations between MRI imaging findings,molecular biology indicators,WHO classification and molecular typing of breast cancer,which can be used to further reflect the biological behavior of breast cancer,For breast cancer patients,to develop a reasonable individual treatment program to provide more reference.