Application value of multi-parametric MRI in preoperative staging of invasive lobular carcinoma of the breast

ZHOU Xin; CHEN Bo; SUN Ji-quan

doi:10.11659/jjssx.03E026017

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Application value of multi-parametric MRI in preoperative staging of invasive lobular carcinoma of the breast

Precise Diagnosis and Treatment of Breast and Thyroid Diseases | 更新时间：2026-10-26

- Application value of multi-parametric MRI in preoperative staging of invasive lobular carcinoma of the breast
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 10, Pages: 849-853(2026)
- 作者机构：
  
  江苏省苏北人民医院医学影像科，江苏扬州 225001
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.03E026017
  CLC： R737.9;R445.2
- Received：04 March 2026，
  
  Published：25 October 2026
- 稿件说明：
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周鑫,陈波,孙继全.多参数MRI在乳腺浸润性小叶癌术前分期中的应用价值[J].局解手术学杂志,2026,35(10):849-853.

ZHOU Xin,CHEN Bo,SUN Ji-quan.Application value of multi-parametric MRI in preoperative staging of invasive lobular carcinoma of the breast[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):849-853.
周鑫,陈波,孙继全.多参数MRI在乳腺浸润性小叶癌术前分期中的应用价值[J].局解手术学杂志,2026,35(10):849-853. DOI： 10.11659/jjssx.03E026017.

ZHOU Xin,CHEN Bo,SUN Ji-quan.Application value of multi-parametric MRI in preoperative staging of invasive lobular carcinoma of the breast[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):849-853. DOI： 10.11659/jjssx.03E026017.

摘要

目的

探讨多参数MRI在乳腺浸润性小叶癌（ILC）术前分期中的临床应用价值。

方法

回顾性分析2017年1月至2024年10月于我院诊疗并经病理证实为ILC的206例患者的影像资料和病理资料，所有患者术前均行动态对比增强MRI（DCE-MRI）及扩散加权成像（DWI）等多参数MRI检查。以病理结果为金标准，依据乳腺ILC的TNM分期标准评价：T分期中肿瘤最大径测量准确性和多灶性病变检出；N分期中表观扩散系数（ADC）值预测腋窝淋巴结转移风险；M分期中对侧乳腺癌的检出。采用受试者工作特征（ROC）曲线评估多参数MRI的诊断效能。

结果

T分期中MRI测量肿瘤最大径误差仅(1.5±1.2) mm（ICC=0.92），显著优于超声测量误差（3.8±2.1） mm（

0.001）；MRI对多灶性病变检出敏感度为86.0%（95%

: 79.0%～93.0%）。N分期中ADC值≤1.10×10

-3

mm²/s预测淋巴结转移的敏感度为92.9%、特异度为88.6%（AUC=0.89

=4.2

=0.003）。M分期中对侧乳腺癌检出敏感度为96.0%（95%

: 92.0%～100%），阴性预测值为99.5%。MRI与病理TNM分期总体一致性高（加权Kappa=0.85）。

结论

多参数MRI通过整合形态学与功能学参数，精准评估ILC的TNM分期，为手术规划及新辅助治疗提供关键依据。

Abstract

Objective

To investigate the clinical application value of multi-parametric MRI in preoperative staging of invasive lobular carcinoma （ILC） of the breast.

Methods

The imaging and pathological data of 206 patients with pathologically confirmed ILC who were treated at our hospital from January 2017 to October 2024 were retrospectively analyzed. All patients underwent preoperative multi-parametric MRI， including dynamic contrast‑enhanced MRI （DCE‑MRI） and diffusion‑weighted imaging （DWI）. Taking pathological results as the gold standard， evaluations were performed according to the TNM staging criteria for ILC of the breast： the accuracy of maximum tumor diameter measurement and the detection of multifocal lesions in T staging； the value of the apparent diffusion coefficient （ADC） in predicting the risk of axillary lymph node metastasis in N staging； the detection of contralateral breast cancer in M staging. Receiver operating characteristic （ROC） curve was adopted to evaluate the diagnostic performance of multi-parametric MRI.

Results

In T staging，the error of the maximumtumor diameter measured by MRI was only （1.5±1.2） mm （ICC=0.92），which was significantly better than that measured by ultrasound （3.8±2.1） mm（

0.001）. The sensitivity of MRI for detecting multifocal lesions was 86.0%（95%

：79.0% to 93.0%）. In N staging，the sensitivity of ADC value ≤1.10×10⁻³ mm²/s in predicting lymph node metastasis was 92.9%，and the specificity was 88.6% （AUC=0.89，

=4.2，

=0.003）. In M staging，the sensitivity for detecting contralateral breast cancer was 96.0%（95%

：92.0% to 100%），and the negative predictive value was 99.5%. The overall consistency between MRI and pathological TNM staging was high （weighted Kappa=0.85）.

Conclusion

Multi-parametric MRI can accurately evaluate the TNM stage of ILC by integrating morphological and functional parameters，providing a key basis for surgical planning and neoadjuvant therapy.

关键词

Keywords

references

邬昊，吕青 . 全球及中国乳腺癌的流行病学趋势及防控启示：2018-2022年《全球癌症统计报告》解读［J］. 中国普外基础与临床杂志， 2024 ， 31 （ 7 ）： 796 - 802 . doi： 10.7507/1007-9424.202407031 http://dx.doi.org/10.7507/1007-9424.202407031 .

王宇宁，杨昭颖，王可人 . Rab22a与乳腺癌：从分子机制到临床特征的研究进展［J］. 中国实验诊断学， 2025 ， 29 （ 3 ）： 357 - 362 . doi： 10.3969/j.issn.1007-4287.2025.03.017 http://dx.doi.org/10.3969/j.issn.1007-4287.2025.03.017 .

崇乐，夏露花，张荣，等 . 乳腺癌超声造影与临床病理特征及肿瘤相关的树突状细胞分布的相关性研究［J］. 实用肿瘤杂志， 2025 ， 40 （ 1 ）： 14 - 19 . doi： 10.13267/j.cnki.syzlzz.2025.003 http://dx.doi.org/10.13267/j.cnki.syzlzz.2025.003 .

黄若冰，徐丹颖，倪文豪，等 . 乳腺浸润性小叶癌组织FOXP1、FOXR2的表达与临床病理特征和预后的关系研究［J］. 现代生物医学进展， 2024 ， 24 （ 20 ）： 3964 - 3966 . doi： 10.13241/j.cnki.pmb. 2024.20.045 http://dx.doi.org/10.13241/j.cnki.pmb.2024.20.045 .

陈晓冰，包凌云 . 乳腺非肿块病变影像学研究进展［J］. 肿瘤学杂志， 2024 ， 30 （ 7 ）： 556 - 562 . doi： 10.11735/j.issn.1671-170X.2024.07.B005 http://dx.doi.org/10.11735/j.issn.1671-170X.2024.07.B005 .

王东沙，鲜于俊杰，庞坤坤，等 . 乳腺浸润性小叶癌与浸润性导管癌的临床和超声特征对比［J］. 中国现代普通外科进展， 2023 ， 26 （ 11 ）： 903 - 905 . doi： 10.3969/j.issn.1009-9905.2023.11.016 http://dx.doi.org/10.3969/j.issn.1009-9905.2023.11.016 .

马永刚，张堃，黄斌，等 . 动态对比增强和扩散加权成像的多参数MRI模型预测乳腺癌肿瘤血管新生的价值［J］. 临床和实验医学杂志， 2022 ， 21 （ 4 ）： 443 - 446 . doi： 10.3969/j.issn.1671-4695. 2022.04.030 http://dx.doi.org/10.3969/j.issn.1671-4695.2022.04.030 .

张旭冉，高润芳 . 乳腺浸润性小叶癌与浸润性导管癌临床病理特征的倾向性匹配分析［J］. 中国医药导报， 2024 ， 21 （ 30 ）： 120 - 128 . doi： 10.20047/j.issn1673-7210.2024.30.23 http://dx.doi.org/10.20047/j.issn1673-7210.2024.30.23 .

程少先，谭诗云，周红 . 乳腺浸润性小叶癌的临床病理学诊断价值研究［J］. 基层医学论坛， 2023 ， 27 （ 19 ）： 82 - 84 . doi： 10.19435/j.1672-1721.2023.19.027 http://dx.doi.org/10.19435/j.1672-1721.2023.19.027 .

郝若妤 . 乳腺钼靶X线检查在乳腺浸润性小叶癌与浸润性导管癌鉴别诊断中的影像学特征［J］. 中国民康医学， 2020 ， 32 （ 16 ）： 104 - 106 . doi： 10.3969/j.issn.1672-0369.2020.16.043 http://dx.doi.org/10.3969/j.issn.1672-0369.2020.16.043 .

叶玲，阮莉金，伍康伟 . MRI及B超对乳腺X线摄影中"局灶性不对称"征象诊断价值的研究［J］. 影像研究与医学应用， 2022 ， 6 （ 23 ）： 127 - 129 . doi： 10.3969/j.issn.2096-3807.2022.23.042 http://dx.doi.org/10.3969/j.issn.2096-3807.2022.23.042 .

Ha SM ， Chae EY ， Cha JH ， et al . Breast MR imaging before surgery： outcomes in patients with invasive lobular carcinoma by using propensity score matching ［J］. Radiology ， 2018 ， 287 （ 3 ）： 771 - 777 . doi： 10.1148/radiol.2018171472 http://dx.doi.org/10.1148/radiol.2018171472 .

Aroney S ， Lloyd T ， Birch S ， et al . Preoperative breast MR imaging influences surgical management in patients with invasive lobular carcinoma ［J］. J Med Imaging Radiat Oncol ， 2024 ， 68 （ 6 ）： 680 - 686 . doi： 10.1111/1754-9485.13754 http://dx.doi.org/10.1111/1754-9485.13754 .

汪培英，任雪倩，陈静，等 . 超声、X线摄影及MRI检查对乳腺黏液癌、浸润性小叶癌、伴大汗腺分化的癌的诊断价值［J］. 临床医学研究与实践， 2020 ， 5 （ 34 ）： 19 - 22 . doi： 10.19347/j.cnki.2096-1413.202034006 http://dx.doi.org/10.19347/j.cnki.2096-1413.202034006 .

曲溪倩，郭丽丽，赵明，等 . 乳腺密度对浸润性小叶癌术前MRI评估的影响［J］. 现代肿瘤医学， 2020 ， 28 （ 2 ）： 301 - 305 . doi： 10.3969/j.issn.1672-4992.2020.02.028 http://dx.doi.org/10.3969/j.issn.1672-4992.2020.02.028 .

周晶，余璇，吴青霞，等 . 基于多参数MRI瘤内和瘤周影像组学特征评估乳腺癌人表皮生长因子受体2状态的价值［J］. 中华放射学杂志， 2023 ， 57 （ 12 ）： 1338 - 1345 . doi： 10.3760/cma.j.cn112149-20221209-00992 http://dx.doi.org/10.3760/cma.j.cn112149-20221209-00992 .

赵青，苏桐，代婷，等 . 基于多参数MRI影像组学联合临床病理变量预测乳腺癌新辅助治疗的敏感性［J］. 磁共振成像， 2024 ， 15 （ 6 ）： 79 - 86 . doi： 10.12015/issn.1674-8034.2024.06.012 http://dx.doi.org/10.12015/issn.1674-8034.2024.06.012 .

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