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• Clinical Article •
Application of multi-parameter MRI and Cyclin D1 in predicting axillary lymph node metastasis of breast cancer
JI Juan  SHENG Meihong  TANG Weixia  GONG Shenchu  ZHANG Yujiao  JIANG Hongbiao  ZHU Yan 

Cite this article as: Ji J, Sheng MH, Tang WX, et al. Application of multi-parameter MRI and Cyclin D1 in predicting axillary lymph node metastasis of breast cancer[J]. Chin J Magn Reson Imaging, 2021, 12(10): 1-5, 11. DOI:10.12015/issn.1674-8034.2021.10.001.


[Abstract] Objective To predict axillary lymph node metastasis of breast cancer using multi-parameter magnetic resonance imaging (MRI) combined with Cyclin D1. Materials andMethods The clinical data of 55 patients with breast cancer in our hospital were retrospectively analyzed. Univariate analysis was used to evaluate the relationship between clinical, pathological, multi parameter MRI features and axillary lymph node metastasis. The ROC curve, area under the curve (AUC), the sensitivity and specificity of breast cancer lesion size, the maximum cortical thickness of ipsilateral axillary lymph nodes, Cyclin D1 expression and combined factors were calculated to evaluate the diagnostic efficiency of axillary lymph node metastasis.Results In 55 cases of breast cancer, there were significant differences in lesion size, apparent diffusion coefficient (ADC) value, number and diameter of blood vessels around the lesion and maximum cortical thickness of ipsilateral axillary lymph node between axillary lymph node metastasis positive and negative groups (P＜0.05). 67.86% (19/28) of Cyclin D1 high expression group and 14.81% (4/27)　of Cyclin D1 low expression group had axillary lymph node metastasis, the difference was statistically significant (P＜0.05). Lesion size, maximum cortical thickness of ipsilateral axillary lymph node and Cyclin D1 high expression increased the risk of axillary lymph node metastasis (OR=1.09, 1.41, 12.57, P＜0.05). According to axillary lymph node metastasis status, the ROC curve of the lesion size, ipsilateral axillary lymph node cortical thickness, Cyclin D1 expression and prediction models (Model 1: ipsilateral axillary lymph node cortical thickness and Cyclin D1 expression; Model 2: maximum diameter of lesion and Cyclin D1 expression; Model 3: maximum diameter of lesion, ipsilateral axillary lymph node cortical thickness and Cyclin D1 expression) were drawn, AUC was 0.808, 0.887, 0.772, 0.791, 0.773 and 0.751. ROC curve analysis showed that the best critical value of the maximum diameter of the lesion was 28.5 mm, the maximum thickness of axillary lymph node cortex was 5.5 mm. The sensitivity of maximum cortical thickness of ipsilateral axillary lymph nodes was 91.3%, and the specificity of Model 2 and 3 was 93.7%.Conclusions Lesion size, maximum cortical thickness of ipsilateral axillary lymph node and Cyclin D1 high expression will increase the risk of axillary lymph node metastasis, which can be used as an independent predictor. The combined model of lesion size and Cyclin D1 high expression or the combined model of lesion size, ipsilateral axillary lymph node cortical thickness and Cyclin D1 high expression can significantly improve the diagnostic specificity, and can be used for preoperative noninvasive prediction of axillary lymph node metastasis in breast cancer.
[Keywords] breast cancer；magnetic resonance imaging；multi-parameter；diffusion weighted imaging；apparent diffusion coefficient；Cyclin D1；lymph node metastasis

JI Juan1   SHENG Meihong1*   TANG Weixia1   GONG Shenchu1   ZHANG Yujiao1   JIANG Hongbiao1   ZHU Yan2  

1 Department of Radiology, the Second Affiliated Hospital of Nantong University, Nantong, 226001, China

2 Department of pathology, the Second Affiliated Hospital of Nantong University, Nantong, 226001, China

Sheng MH, E-mail: smh4127@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Jiangsu Province Maternal and Child Health Research Project (F202037); The "Six One" Research Funding Program for High-level Health Talents in Jiangsu Province (LGY2018036, LGY2020048).
Received  2021-05-17
Accepted  2021-07-06
DOI: 10.12015/issn.1674-8034.2021.10.001
Cite this article as: Ji J, Sheng MH, Tang WX, et al. Application of multi-parameter MRI and Cyclin D1 in predicting axillary lymph node metastasis of breast cancer[J]. Chin J Magn Reson Imaging, 2021, 12(10): 1-5, 11. DOI:10.12015/issn.1674-8034.2021.10.001.

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