高频超声在乳腺癌新辅助化疗中的监测价值  

Monitoring the response of breast cancer to neoadjuvant chemotherapy using high frequency ultrasonography

作　　者：胡军利[1] 向明[2] 王文伟[2] 陈东风[1] 

机构地区：[1]济宁医学院附属医院超声科,山东济宁272029 [2]贵阳医学院附属医院超声中心,贵州贵阳550004

出　　处：《中国医学影像技术》2007年第9期1333-1336,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨高频超声在乳腺癌新辅助化疗中的治疗监测和疗效评估价值。方法52例乳腺癌患者58个肿瘤在新辅助化疗前及化疗结束后,应用高频超声对肿瘤的大小和血流情况进行监测,其中16例患者(16个肿瘤)于化疗第二周期结束后增加了一次超声检查。所有超声检查结果与术后病理结果对照分析。结果新辅助化疗后超声测量乳腺癌原发灶各径线均明显缩小,血流丰富程度降低,最大血流速度(Vmax)和阻力指数(RI)明显降低(P<0.01)。术前超声测量的残余癌最大直径与病理测残余癌最大直径显著相关(r=0.894,P<0.01)。超声评估原发肿瘤缓解的总有效率为79.31%(46/58),其中3例(5.17%)达病理完全缓解;超声淋巴结完全缓解率为26.67%(8/30),病理淋巴结完全缓解率为20%(6/30)。12例患者根据化疗早期的超声检查及时调整了治疗方案,避免了无效化疗。结论高频超声对乳腺癌新辅助化疗的疗效评估方便、准确,化疗早期的超声监测有助于临床优化治疗方案。Objective To investigate the value of high frequency ultrasonography （US） in monitoring and assessing tumor response of breast cancer to neoadjuvant chemotherapy （NAC）. Methods Fifty-two patients with 58 breast tumors received NAC for 3--4 cycles. Tumor sizes and the blood flow condition were assessed before and after chemotherapy using high frequency US. After 2 cycles of NAC, sixteen patients with 16 breast tumors underwent one additional US examination. All US findings were compared with postoperative pathological findings. Results Tumor sizes, the signal grading of blood flow, values of Vmax and RI of primary breast cancer measured by US decreased obviously （P〈0.01） after NAC. Correlation of pathology and preoperative US as measured by the longest diameter of residual tumor was excellent （r= 0. 894, P〈0.01）. The total effective rate of primary breast tumor assessed by US was 79.31% （46/58）, and 3 patients （5. 17%）obtained pathological complete response. The complete response rate of positive axillary lymph node assessed by US was 26.67% （8/30） and that assessed by pathology was 20% （6/30）. According to the early monitoring by US, twelve patients avoided ineffective chemotherapy by modifying the regimen in time. Conclusion High frequency US assess the response of NAC conveniently and accurately. The early monitoring by US helps to tailor therapy.

关 键 词：高频 超声检查 乳腺肿瘤 新辅助化疗 肿瘤缓解 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]