【摘要】 目的探讨磁共振T₂WI瘤周水肿征象对浸润性乳腺癌早期复发的诊断价值。方法回顾性分析我院116例浸润性乳腺癌患者的临床病历资料,根据T₂WI瘤周水肿征象分为阳性组与阴性组。比较两组浸润性乳腺癌的临床病理特征以及术后早期复发与T₂WI瘤周水肿的关系,Kaplan-Miere法绘制患者无病生存曲线,采用Cox风险比例回归模型分析影响乳腺癌术后复发的因素。结果 116例乳腺癌患者中,T₂WI瘤周水肿阳性39例、阴性77例;与T₂WI瘤周水肿阴性组比较,阳性组T分期、N分期更高,且Ki-67高表达率以及淋巴管浸润的比例更高,ER/PR、HER-2阳性率更低（P <0. 05）。T₂WI瘤周水肿征阳性组和阴性组的3年无病生存率分别为56. 4%、89. 6%,差异有统计学意义（P <0. 05）。单因素分析显示,T分期、N分期、淋巴管浸润、T₂WI瘤周水肿征与乳腺癌术后早期复发有关（P <0. 05）。多因素分析显示,T₂WI瘤周水肿征阳性（HR=3. 226,95%CI:1. 033～10. 078,P=0. 044）、N2～N3（HR=3. 477,95%CI:1. 122～10. 775,P=0. 031）是浸润性乳腺癌早期复发的独立危险因素。结论术前磁共振T₂WI瘤周水肿征象对浸润性乳腺癌早期复发具有较大的预测价值。更多还原

【Abstract】 Objective To investigate the diagnostic value of magnetic resonance T₂ WI peritumoral edema signs in early recurrence of invasive breast cancer. Methods The clinical data of 116 patients with invasive breast cancer in our hospital were retrospectively analyzed. According to the signs of peritumoral edema on T₂ WI,the patients were divided into positive group and negative group. The clinicopathological features of invasive breast cancer and the relationship between the postoperative early recurrence and preoperative peritumoral edema on T₂ WI were compared. Kaplan-Miere method was used to draw the survival curve of disease free survival,and Cox risk proportional model was used to analyze the factors affecting recurrence of breast cancer after operation. Results Peritumoral edema on T₂ WI was positive in 39 cases and negative in 77 cases. Compared with the negative group of peritumoral edema on T₂ WI,the positive group had higher T stage and N stage,higher Ki-67 expression rate and lymphatic infiltration rate,lower ER/PR and HER-2 positive rate（ P < 0. 05）. The three-year disease-free survival rates of the positive and negative groups with T₂ WI peritumoral edema sign were 56. 4% and 89. 6%,with significant difference（ P < 0. 05）. Univariate analysis showed that T stage,N stage,lymphatic vessel infiltration and peritumoral edema sign of T₂ WI were associated with early recurrence of breast cancer after operation（ P < 0. 05）. Multivariate analysis showed that positive peritumoral edema sign of T₂ WI（ HR = 3. 226,95% CI: 1. 033-10. 078,P =0. 044） and N2-N3（ HR = 3. 477,95% CI: 1. 122-10. 775,P = 0. 031） were independent risk factors for early recurrence of invasive breast cancer. Conclusion Preoperative MR T₂ WI signs of peritumoral edema have great predictive value for early recurrence of invasive breast cancer.更多还原