대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제83권1호
  • /
  • Pages.149-161
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  • 2022
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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3T 자기공명영상에서 비특이 침윤성 유방암의 컴퓨터보조진단 인자들과 병리적 면역조직화학 표지자들과의 상관성

Computer-Aided Diagnosis Parameters of Invasive Carcinoma of No Special Type on 3T MRI: Correlation with Pathologic Immunohistochemical Markers

  • 정진호 (가톨릭대학교 의과대학 인천성모병원 영상의학과) ;
  • 박창숙 (가톨릭대학교 의과대학 인천성모병원 영상의학과) ;
  • 이정휘 (가톨릭대학교 의과대학 인천성모병원 영상의학과) ;
  • 김기준 (가톨릭대학교 의과대학 인천성모병원 영상의학과) ;
  • 김현숙 (가톨릭대학교 의과대학 은평성모병원 영상의학과) ;
  • 전선영 (가톨릭대학교 의과대학 인천성모병원 병리과) ;
  • 오세정 (가톨릭대학교 의과대학 인천성모병원 외과)
  • Jinho Jeong (Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chang Suk Park (Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jung Whee Lee (Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kijun Kim (Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hyeon Sook Kim (Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Sun-Young Jun (Departments of Pathology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Se-Jeong Oh (Departments of Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea)
  • 투고 : 2021.04.14
  • 심사 : 2021.06.15
  • 발행 : 2022.01.01
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초록

목적 3-tesla (이하 T) 자기공명영상에서 비특이 침윤성 유방암의 컴퓨터보조진단 인자들과 병리적 면역조직화학 표지자들과의 상관성을 알아보고자 하였다. 대상과 방법 2018년 1월부터 2019년 4월까지 비특이 침윤성 유방암으로 진단받은 총 94명의 3T 자기공명영상에서 컴퓨터보조진단 시스템을 통해 얻은 혈관조영부피, 최대 조영증강, 조기 및 지연 조영증강 양상과 면역화학인자와 유방암의 분자형 아형과의 상관성을 Dwass, Steel, Critchlow-Fligner 비교 분석과 이분형 로지스틱 회귀 분석을 이용하여 후향적으로 연구하였다. 결과 혈관조영부피가 큰 비특이 침윤성 유방암이 핵등급과 조직학적 등급이 높고, 림프절 전이가 있고, 에스트로겐 수용체/프로게스테론 수용체 음성, 인간 표피성장인자수용체 2/Ki-67 양성이 많았다. Ki-67 양성인 비특이 침윤성 유방암에서 지연기 소실 성분 비율이 높고 지연기 지속 조영증강 비율이 낮았다. 이항회귀분석에서는 컴퓨터보조진단 시스템의 요소 중 혈관조영부피 인자가 독립적으로 핵등급, 조직학적 등급, 림프절 전이, 에스트로겐/프로게스테론 수용체, 인간 표피성장인자수용체 2와 Ki-67과 상관성이 있고, 지연기 소실 및 지속 조영증강 인자가 Ki-67과 상관성이 있었다. 결론 조영증강 유방 MRI 컴퓨터보조진단 시스템 인자 중 혈관조영부피 요소와 지연기 소실/지속 조영증강 비율이 예후 예측 인자로 알려진 면역화학인자들과 연관성이 높아 임상적 예후 예측 인자로서 이용될 수 있을 것으로 사료된다.

Purpose To investigate the correlation between computer-aided diagnosis (CAD) parameters in 3-tesla (T) MRI and pathologic immunohistochemical (IHC) markers in invasive carcinoma of no special type (NST). Materials and Methods A total of 94 female who were diagnosed with NST carcinoma and underwent 3T MRI using CAD, from January 2018 to April 2019, were included. The relationship between angiovolume, curve peak, and early and late profiles of dynamic enhancement from CAD with pathologic IHC markers and molecular subtypes were retrospectively investigated using Dwass, Steel, Critchlow-Fligner multiple comparison analysis, and univariate binary logistic regression analysis. Results In NST carcinoma, a higher angiovolume was observed in tumors of higher nuclear and histologic grades and in lymph node (LN) (+), estrogen receptor (ER) (-), progesterone receptor (PR) (-), human epidermal growth factor 2 (HER2) (+), and Ki-67 (+) tumors. A high rate of delayed washout and a low rate of delayed persistence were observed in Ki-67 (+) tumors. In the binary logistic regression analysis of NST carcinoma, a high angiovolume was significantly associated with a high nuclear and histologic grade, LN (+), ER (-), PR (-), HER2 (+) status, and non-luminal subtypes. A high rate of washout and a low rate of persistence were also significantly correlated with the Ki-67 (+) status. Conclusion Angiovolume and delayed washout/persistent rate from CAD parameters in contrast enhanced breast MRI correlated with predictive IHC markers. These results suggest that CAD parameters could be used as clinical prognostic, predictive factors.

키워드

과제정보

Statistical evaluation was supported by the Department of Biostatistics of the Catholic Research Coordinating Center.

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