磁共振在评价乳腺癌新辅助化疗疗效中的应用  

Application of Magnetic Resonance Imaging in Evaluation of Neoadjuvant Chemotherapy Response in Breast Cancer Patients

作　　者：胡丽霞[1] 马捷[1] 贾桂静[1] 朱进[1] 张景忠[1] 

机构地区：[1]暨南大学第二临床医学院放射科,广东深圳518020

出　　处：《黑龙江医学》2016年第6期523-525,共3页Heilongjiang Medical Journal

基　　金：深圳市科技计划项目(JCYJ2015043101146281)

摘　　要：目的 探讨磁共振（MRI）在乳腺癌新辅助化疗（NAC）疗效评价中的应用价值。方法 选取2011-10—2015-10间在暨南大学第二临床医学院经过病理证实的乳腺癌患者60例,年龄为25-70岁。接受2-4个周期的新辅助化疗（NAC）,分别在NAC前后进行两次MRI检查,NAC后3-4周实施手术。根据MRI检查指标、实体瘤反应评价标准及术后切除肿瘤灶的病理检查对NAC疗效进行评价。结果 NAC后经MRI检查临床评估的有效率为73.3%（44/60）,术后病理评估NAC有效率为78.3%（47/60）,经检验两种方法具有显著的相关性（P〈0.05）。NAC前后病灶体积、大小、ADC值等MRI相关指标差异有统计学意义（P〈0.05）;NAC后TIC类型与NAC前相比,有由Ⅲ型转向Ⅰ型的趋势,差异有统计学意义（P〈0.05）。结论 MRI检查可以准确反映乳腺癌NAC后肿瘤病灶的变化,在评价乳腺癌NAC疗效方面具有重要的临床价值。Objective To evaluate the value of magnetic resonance imaging （MR） in evaluating the tumor response to neoadjuvant chemotherapy （NAC） in breast cancer. Methods During Oct. 2011 and Oct. 2015, 60 patients with pathologically confirmed breast cancer, 25 - 70 years old, were enrolled into this study. All patients received 2 - 4 cycles of NAC, surgical treatment was performed 3 to 4 weeks after the end of NAC. MR[ were made before and after NAC. The response to NAC were evaluated based onthe response evaluation criteria in solid tumors （RECIST）, pathological examination and MR1 analysis. Results The effective rate of NAC evaluated by MRI （clinical evaluation） was 73.3% （44/60）, while it was 78.3% （47/60） evaluated by pathological examination （pathological evalua- tion）. There was significant correlation between clinical evaluation and pathological evaluation （P 〈 0.05 ）. There were significant differences in MRI related parameter, including tumor volume, tumor size and ADC before and after NAC （P 〈0.05）. The type of TIC after NAC showed a tendency shift type m to type I compared with it before NAC, and the differences were statistically siginificant（ P 〈 0.05 ）. Conclusion MRI could accurately assess the changes in tumor volume and biological activity after NAC, and therefore it is useful for evaluating response to neoadjuvant chemotherapy in breast cancer patients.

关 键 词：磁共振成像 乳腺癌 新辅助化疗 

分 类 号：R737.9[医药卫生—肿瘤]