【摘要】 目的探讨动态对比增强磁共振成像（DCE-MRI）多功能直方图参数（Ktrans、Kep、Ve）与三阴乳腺癌程序性死亡配体1（PD-L1）表达的相关性。方法收集2019年12月至2020年6月在河北省唐山市人民医院经病理证实的三阴乳腺癌患者52例。术前或穿刺前行DCE-MRI检查,计算患者病灶MRI多功能参数（Ktrans、Kep、Ve）的直方图参数,免疫组织化学方法检测各病灶PD-L1的阳性表达情况,PD-L1的表达采用肿瘤阳性细胞评分（TPS）及免疫细胞评分法（IC）两种评分方法。依据PD-L1表达情况分为阴性组和阳性组,评价各直方图定量参数与乳腺癌PD-L1阳性表达的意义。结果三阴乳腺癌TPS评分系统中,PD-L1的阳性表达率为21.15%,IC评分系统中,PD-L1的阳性表达率为40.38%。在IC评分组中,PD-L1阳性组Ktrans均值、Ktrans P₅₀值及Ktrans P₇₅值高于阴性组（P <0.05）,PD-L1阳性组Kep均值、Kep P₂₅值及Kep P₅₀值高于阴性组（P <0.05）。在TPS评分组中,PD-L1评分状态在MRI各功能参数中比较,差异无统计学意义（P> 0.05）。结论在IC评分组中,PD-L1阳性的三阴乳腺癌患者具有更高的Ktrans及Kep。因此,MRI多功能参数可能是预评估三阴乳腺癌患者能否免疫治疗的有效的影像学指标。更多还原

【Abstract】 Objective To explore the correlation between dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI） multi-function histogram parameters（Ktrans, Kep, Ve） and the expression of programmed death ligand 1（PD-L1） in triple-negative breast cancer. Methods A collection of 52 patients with triple-negative breast cancer who were pathologically confirmed in the Tangshan People’s Hospital, Hebei Province from December 2019 to June 2020.Before surgery or before puncture, DCE-MRI was performed to calculate the histogram parameters of the MRI multifunction parameters（Ktrans, Kep, Ve） of the patient’s lesions, and the positive expression of PD-L1 in each lesion was detected by immunohistochemistry. The expression of PD-L1 was detected by two scoring methods: tumor positive cell score（TPS） and immune cell score（IC）. According to the expression of PD-L1, they were divided into negative group and positive group, and the significance of each histogram quantitative parameter and the positive expression of PD-L1 in breast cancer was evaluated. Results In the TPS scoring system for triple-negative breast cancer, the positive expression rate of PD-L1 was 21.15%, and in the IC scoring system, the positive expression rate of PD-L1 was 40.38%.In the IC score group, the mean Ktrans, Ktrans P₅₀, and Ktrans P₇₅ values of the PD-L1 positive group were higher than those of the negative group（P < 0.05）. The mean Kep, Kep P₂₅, and Kep P₅₀ values of the PD-L1 positive group were higher than those of the negative group（P < 0.05）. In the TPS scoring group, the PD-L1 scoring status was compared in various functional parameters of MRI, and the difference was not statistically significant（P > 0.05）. Conclusion In the IC score group, PD-L1 positive triple-negative breast cancer patients have higher Ktrans and Kep. Therefore, MRI multifunctional parameters may be an effective imaging index for pre-evaluating whether patients with triple-negative breast cancer can be immunotherapy.更多还原