Abstract
目的 探讨乳腺良、恶性病变MR动态增强(DCE)参数与肿瘤血管生成的关系.方法 对51例乳腺良、恶性病变患者行前瞻性DCE-MR检查,计算动态增强参数:最大增强线性斜率(Smax)、增强峰值(PH)、峰值时间(Tpeak).所有病例手术病理标本行免疫组织化学染色,测定微血管密度(MVD)计数和血管内皮生长因子(VEGF)表达,分析各动态增强参数与乳腺癌MVD和VEGF表达的相关性.并比较29例乳腺癌与12例乳腺纤维腺瘤、10例乳腺病、10例癌旁正常组织MVD计数和VEGF表达的差别.结果 乳腺癌Smax(2.04±1.8;r=0.807,P＜0.01)、PH(678±260;r=0.697,P＜0.01)与MVD呈正相关,Tpeak(69±38)与MVD呈负相关(r=-0.425,P＜0.05).乳腺癌组MVD计数[(65.09±15.81)个/200倍视野]明显高于纤维腺瘤组、乳腺腺病组及癌旁正常组织组(P值分别为0.043、0.018、0.002).69%(20/29)乳腺癌VEGF表达阳性,也明显高于其余各组(P值分别为0.035、0.007、0.001).乳腺癌边缘区域的MVD(60.38±24.14)个/200倍视野,高于中央区域(37.64±16.52)个/200倍视野;(t=2.635,P=0.016).腋窝淋巴结转移组的MVD(73.23±23.02)个/200倍视野,高于无转移组(59.34±18.03)个/200倍视野,(t=2.303,P=0.031).结论 乳腺癌部分MR-DCE参数与MVD、VEGF相关,能较客观地反映乳腺癌血管生成状况,其MVD计数和VEGF表达明显高于乳腺良性病变及癌旁正常组织。
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