连续超声引导下Mammotone穿刺活检在乳腺癌新辅助化疗疗效判定中的意义  

The curative effect evaluation of continuous ultrasound-guided Mammotone biopsy technique on the neoadjuvant chemotherapy of breast cancer

作　　者：曹效忠[1] 李瑾[1] 王雷[1] 马菲[1] 刘岩松[1] 王义民[1] 周兴璐[1] 仲雷[1] 郭宝良[1] 

机构地区：[1]哈尔滨医科大学附属第二医院乳腺外科,150086

出　　处：《中国医师进修杂志》2013年第20期1-4,共4页Chinese Journal of Postgraduates of Medicine

基　　金：黑龙江省卫生厅科研课题资助项目（2011-059）

摘　　要：【摘要】目的探讨连续超声引导下Mammotone穿刺活检在乳腺癌新辅助化疗疗效判定中的临床意义。方法选取24例Ⅱ或Ⅲ期接受TEC方案新辅助化疗的乳腺癌患者，分别在新辅助化疗前和2个疗程后接受超声引导下Mammotone穿刺活检，进行前后对比的病理学评价，同时结合超声评价进行综合分析。结果2个疗程后，超声评价：18例肿瘤体积明显减少（完全缓解3例和部分缓解15例），6例肿瘤体积减少不明显或增大（无变化3例和进展3例）；病理学评价：Miller-Payne分级5级2例，4级18例，3级1例，2级2例，1级1例。超声评价6例肿瘤体积减少不明显或增大患者中，2例病理学评价时见肿瘤细胞明显减少，瘤床纤维组织增生（MiHer-Payne分级为4级）。超声对乳腺癌新辅助化疗疗效评价有效率为75．O％（18／24），而病理学评价有效率为83．3％（20124），两者比较差异无统计学意义（P〉0．05），具有较好的一致性（Kappa=0．750）。结论超声可以对多数乳腺癌新辅助化疗的疗效进行评价；病理学评价是乳腺癌新辅助化疗疗效评价的“金标准”；连续超声引导下Mammotone穿刺活检技术对超声评价疗效欠佳者，可能更有实际临床研究意义。[ Abstract ] Objective To investigate the curative effect evaluation of continuous ultrasound-guided Mammotone biopsy technique on the neoadjuvant chemotherapy （NCT） of breast cancer. Methods Twenty- four cases with II or In period breast cancer who accepted TEC project NCT were selected. The patients accepted continuous ultrasound-guided Mammotone biopsy respectively before NCT and after completion of two cycles of NCT,the pathology evaluation was contrasted in combination with the ultrasonic evaluation analysis. Results After two cycles of NCT, ultrasonic evaluation： 18 cases＇ tumor volume were significantly reduced （complete remission in 3 cases and partial remission in 15 cases） ,6 cases＇ tumor volume were not obviously reduced or increased （stable disease in 3 cases and progressive disease in 3 cases）. Pathological evaluation： Miller-Payne grade 5 grade in 2 cases,4 grade in 18 cases,3 grade in 1 case,2 grade in 2 cases, 1 grade in 1 case. Six cases＇ tumor volume were not obviously reduced or increased by ultrasonic evaluation,2 cases＇ tumor cells of pathological evaluation were significantly reduced ,and tumor bed fibrous tissue hyperplasia （Miller-Payne grade 4 grade）. Ultrasound on breast cancer NCT of the eitlciency evaluation was 75.0% （18/24）, while the pathological evaluation efficiency was 83.3% （20/24）,there was no statistical difference （P〉 0.05）, had a good consistency （Kappa = 0.750）. Conclusions Ultrasound can be used for the evaluation of the majority of breast cancer response to the NCT,while the pathological evaluation is the ＂gold standard＂ which to assess the efficacy of the NCT in breast cancer. The continuous ultrasound-guided Mammotone biopsy technique may be more practical significance of the clinical application for the case that is poor curative effect evaluation with the ultrasonic imaging.

关 键 词：乳腺肿瘤 抗肿瘤联合化疗方案 活组织检查 

分 类 号：R737.9[医药卫生—肿瘤]