应变力超声弹性成像预测乳腺癌患者新辅助化疗后病理完全缓解  

Strain ultrasound elastography predicting pathological complete response to neoadjuvant chemotherapy in breast cancer patients

作　　者：马燕[1] 李晶[1] 任卫东[1] 邓力军[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,辽宁沈阳110004

出　　处：《中国介入影像与治疗学》2016年第7期416-420,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：中国医科大学附属盛京医院院内课题(MD63)

摘　　要：目的评估应变力超声弹性成像(SUE)技术预测乳腺癌患者新辅助化疗(NAC)后病理完全缓解(pCR)的效能。方法收集乳腺癌患者60例,采用SUE评估NAC前肿瘤的弹性评分和弹性应变率比值,记录肿瘤穿刺活检的免疫组化结果,术后病理参照Miller-Panye分级法评估病理反应性,采用Logistic回归分析获得影响NAC后pCR的独立影响因素。绘制不同指标预测pCR结局的ROC曲线,并计算曲线下面积(AUC),Z检验比较不同指标的AUC。结果高弹性评分是pCR的独立影响因素。弹性应变率比值的预测效能最佳,AUC为0.92±0.03,且与Ki-67(0.60±0.08)的AUC比较差异有统计学意义(P<0.01);而弹性应变率比值与弹性评分(0.89±0.05)的AUC差异无统计学意义(P=0.36)。结论 SUE评估乳腺癌硬度可预测NAC后pCR结局,在乳腺癌的个体化精准治疗中有重要作用。Objective To evaluate the predictive diagnostic performance of strain ultrasound elastography （SUE） in pathological complete response （pCR） after neoadjuvant chemotherapy （NAC） in breast cancer patients. Methods Sixty breast cancer patients were consecutively included. The strain ratio and strain score was assessed by SUE before biopsy. Pathologic response was evaluated according to Miller-Panye grading system, and immunohistochemical analysis was recorded. Logistic regression analysis was performed to explicit the independent risk factors of pCR. The ROC curve and the area under the ROC （AUC） were calculated, Z test was used to compare the differences between AUCs. Results High strain score was the independent risk factor for pCR. The predictive value of the strain ratio was the best among all variables, the AUC was 0.92±0.03. The difference of AUC between Ki-67 （0.60±0.08） and strain ratio was significant （P〈0.01）; but the difference between strain ratio and strain score （0.89±0.05） had no significant （P=0.36）. Conclusion The stiffness evaluated by SUE is variable for predicting the pCR to NAC, SUE plays an important role in individualized treatment of breast cancer.

关 键 词：乳腺肿瘤 弹性成像技术 新辅助化疗 超声检查 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]