MRI及B超对乳腺癌新辅助化疗疗效评价的前瞻性研究  

Prospective study on the role of MRI and B ultrasonography in evaluating the tumor response to neoadjuvant chemotherapy in breast cancer

作　　者：叶京明[1] 徐玲[1] 王东民[1] 赵建新[1] 张澜波[1] 段学宁[1] 刘荫华[1] 

机构地区：[1]北京大学第一医院乳腺疾病中心,100034

出　　处：《中华外科杂志》2009年第5期349-352,共4页Chinese Journal of Surgery

摘　　要：目的观察B超及MRI在乳腺癌新辅助化疗疗效评价中的作用。方法对2007年7月至2008年7月接受新辅助化疗的85例原发性乳腺癌患者进行前瞻性研究，对比分析手术前新辅助化疗前、化疗2周期后、化疗4周期后患者的B超、MRI影像学资料，参照实体瘤疗效评价标准（RECIST）评价疗效，并与术后组织病理学检查进行比较。结果入组患者共85例，均完成4周期新辅助化疗。MRI评估完全缓解（cR）者0例，部分缓解（PR）者56例，疾病稳定（SD）者27例，疾病进展（PD）者2例；B超评估CR者0例，PR者52例，SD者31例，PD者2例。MRI及B超对新辅助化疗后残余肿瘤检测的阳性预测值均为94．1％。其中新辅助化疗后残余肿瘤最大径线MRI测量结果与病理镜下测量结果高度相关（r=0．783，P〈0．05），B超对残余肿瘤测量结果与病理镜下测量结果中度相关（r=0．576，P〈0．001）。结论MRI是乳腺癌新辅助化疗临床疗效评价的可靠方法，其准确性高于B超。Objective To evaluate the role of breast B ultrasonography and magnetic resonance imaging in assessing the tumor response to neoadjuvant chemotherapy in breast cancer. Methods Eighty-five patients with breast cancer diagnosed by core needle biopsy received neoadjuvant chemotherapy entered this prospective study. Breast B uhrasonography and dynamic enhanced MRI was performed before chemotherapy induction, after the second course and the fourth course of chemotherapy prior to the surgery. Clinical evaluation was made through the tumor reduction measured by B ultrasonography and MRI, based on the response evaluation criteria in solid tumors （RECIST）. Results Measured by dynamic enhanced MRI, 56 patients got partial response （PR）, 27 got stable disease （SD） and 2 got progressive disease （PD）, none complete response （CR）. Measured by B ultrasouography, 52 patients got PR, 31 got SD, 2 got PD, no CR. Residual tumor size after chemotherapy on MRI correlated well with post-operative pathologic findings （ r = 0. 783 ,P 〈 0. 05 ） , and B uhrasonography correlated moderately with microscopic findings （ r = 0. 576, P 〈0. 001 ）. Conclusion Dynamic enhanced MRI is a reliable method to evaluate tumor response to neoadjuvant chemotherapy in breast cancer.

关 键 词：乳腺肿瘤 磁共振成像 超声检查 乳房 新辅助化疗 

分 类 号：R686[医药卫生—骨科学]