Objectives: Currently, it is difficult to assess the expression status of hormone receptor (HR) in breast malignant tumors with human epidermal growth factor receptor 2 (HER-2)-positive in the early preoperative stage, and it is difficult to predict whether it is non-invasively. This study aims to explore the value of MRI on the different HR expression status (HR+/HR-) in HER-2 positive breast cancer.
Methods: Thirty patients with HR+ HER-2-positive breast cancer (HR+ group) and 23 patients with HR-HER-2-positive breast cancer (HR- group) from the First Hospital of Hunan University of Traditional Chinese Medicine between January 7, 2015 and November 26, 2021 were selected as subjects, and all the patients were examined by MRI and all were confirmed by surgery or pathological biopsy puncture. The immunohistochemical staining results were used as the gold standard to analyze the basic clinical conditions, peri-lesion conditions and MRI sign characteristics in the 2 groups.
Results: There were all significant differences in terms of mass margins, internal reinforcement features, and apparent diffusion coefficient (ADC) values between the HR+ group and the HR- group (all P<0.05). The logistic multivariate regression model showed that: when the lesion presented as a mass-type breast cancer on MRI, the internal enhancement features of the lesion were an independent predictor for differentiation in the 2 types of breast cancer [odds ratio (OR)=5.95, 95% CI: 1.223 to 28.951, P<0.05], and the mass margin (OR=0.386, 95% CI: 0.137 to 1.082, P>0.05) and ADC value (OR=0.234, 95% CI: 0.001 to 105.293, P>0.05) were not the independent predictors in distinguishing the 2 types of breast cancer.
Conclusions: Multiparametric MRI has good diagnostic value for HR expression status in HER-2-positive breast cancer. Combined logistic regression analysis to construct a predictive model may be helpful to the identical diagnosis.
目的: 目前临床上术前早期对人表皮生长因子受体-2(human epidermal growth factor receptor 2，HER-2)阳性乳腺恶性肿瘤中激素受体(hormone receptor，HR)表达状态的评估存在困难，无创而有效的预测难以达成。本研究旨在探讨磁共振成像(magnetic resonance imaging，MRI)对HER-2阳性乳腺癌中不同HR表达状态(HR+/HR-)的鉴别价值。方法: 选取2015年1月7日至2021年11月26日于湖南中医药大学第一附属医院接受治疗的30例HR+ HER-2阳性乳腺癌(HR+组)及23例HR- HER-2阳性乳腺癌(HR-组)患者为受试对象，所有患者均经过MRI检查，且均经过手术或病理活检证实。以免疫组织化学染色检查结果作为金标准，分析两组的基本临床情况、病灶周围情况及MRI征象特点。结果: HR+组与HR-组的肿块边缘、病灶内部强化特征、表观扩散系数(apparent diffusion coefficient，ADC)值差异均有显著的统计学意义(均P<0.05)。Logistic多因素回归分析显示：当病灶在MRI上表现为肿块型乳腺癌时，病灶内部强化特征是区分两组乳腺癌的独立预测因素[比值比(odds ratio，OR)=5.95，95% CI：1.223~28.951，P<0.05]，而肿块边缘(OR=0.386，95% CI：0.137~1.082，P>0.05)与ADC值(OR=0.234，95% CI：0.001~105.293，P>0.05)不属于区分两者的独立预测因素。结论: 多参数MRI对HER-2阳性乳腺癌中HR不同的表达状态具有良好的诊断价值。联合logistic回归分析构建预测模型可对其鉴别诊断提供一定的帮助。.
Keywords: breast cancer; hormone receptor; human epidermal growth factor receptor-2; magnetic resonance imaging.