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目的:探讨乳腺癌新辅助化疗前后MR灌注成像与肿瘤微血管密度之间的相关性。方法:对20例乳腺癌患者在新辅助化疗前及化疗4个周期后手术前行磁共振灌注成像,并对化疗前穿刺及术后标本行免疫组织化学检测肿瘤的微血管密度,分析MR灌注成像最大信号丢失率与微血管密度在化疗前后的变化情况及其相关性。结果:按照实体肿瘤治疗反应评估标准(RECIST)指南,20例患者中,化疗有反应组16例(80%),无反应组4例(20%)。化疗后肿瘤灌注最大信号丢失率明显低于化疗前(P<0.05),有反应组最大信号丢失率明显下降(P<0.05),而无反应组最大信号丢失率未发生显著变化,P>0.05。化疗后肿瘤微血管密度明显降低(P<0.05),有反应组的CD34表达明显下降(P<0.05),而无反应组CD34表达的变化无统计学意义,P>0.05。化疗前后Ratio值变化率与CD34变化率之间存在正相关关系,r=0.703,P<0.05。结论:乳腺癌新辅助化疗前后磁共振灌注成像与微血管密度存在一定的相关性,可在一定程度上反映肿瘤的血管生成情况。
Objective: To investigate the correlation between MR perfusion imaging and tumor microvessel density before and after neoadjuvant chemotherapy in breast cancer. Methods: Twenty patients with breast cancer underwent magnetic resonance perfusion imaging before neoadjuvant chemotherapy and 4 cycles after chemotherapy, and the microvessel density of tumor was detected by immunohistochemical technique before puncture and postoperative chemotherapy. MR perfusion imaging Changes of maximum signal loss rate and microvessel density before and after chemotherapy and their correlation. Results: According to the RECIST guidelines, 16 patients (80%) responded to chemotherapy and 4 patients (20%) did not respond to chemotherapy. The maximum signal loss rate after chemotherapy was significantly lower than that before chemotherapy (P <0.05), and the maximum signal loss rate in response group was significantly decreased (P <0.05), while the maximum signal loss rate in non-response group did not change significantly, P> 0.05 . The tumor microvessel density was significantly decreased after chemotherapy (P <0.05), and the expression of CD34 in response group was significantly decreased (P <0.05), while the expression of CD34 in non-response group was not significantly changed (P> 0.05). The ratio of change of Ratio before and after chemotherapy had a positive correlation with the rate of change of CD34, r = 0.703, P <0.05. Conclusion: There is a certain correlation between MR perfusion imaging and microvessel density before and after neoadjuvant chemotherapy in breast cancer, which can reflect the tumor angiogenesis to a certain extent.