声脉冲辐射力成像技术评价乳腺癌新辅助化疗疗效的价值研究  

Accuracy of acoustic radiation force impulse imaging in predicting the effect of neoadjuvant chemotherapy for breast cancer

作　　者：于秋杰[1] 姜智允 孟巍 YU Qiujie;JIANG Zhiyun;MENG Wei(Department of Medical hnaging Center, the Affiliated Tumor Hospital of Harbin Medical University, Harbin 150081, Heilongjiang, China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院影像中心,哈尔滨1500810

出　　处：《癌症进展》2018年第3期306-308,共3页Oncology Progress

基　　金：黑龙江省青年科学基金项目(QC2015110)

摘　　要：目的探讨声脉冲辐射力成像技术(ARFI)在乳腺癌新辅助化疗疗效评价中的应用价值。方法选取42例原发性浸润性乳腺癌患者(共42个病灶),所有患者均于新辅助化疗后行外科手术治疗。应用ARFI技术测量新辅助化疗前后病灶最大弹性值变化率。以Millen-Payne(MP)分级系统作为病理反应的评价依据,Ⅰ~Ⅲ级为组织学非显著反应,Ⅳ~Ⅴ级为组织学显著反应。以手术病理诊断为金标准,应用受试者工作特征曲线(ROC)评价ARFI的诊断价值。结果 42例乳腺癌组织中,69.05%(29/42)为组织学显著反应,30.95%(13/42)为组织学非显著反应。通过ROC曲线确定的评价新辅助化疗有效和无效的VTQ值变化率诊断界值为29%(曲线下面积为0.925,95%CI:0.863~0.987),敏感度为91.1%,特异度为83.3%,准确度为87.7%。新辅助化疗后,组织学显著反应组乳腺癌患者的VTQ值(弹性值)明显低于化疗前,差异有统计学意义(P﹤0.01)。结论 ARFI技术可通过定量测量新辅助化疗前后乳腺癌硬度变化,为乳腺癌新辅助化疗的疗效评估提供新方向。Objective To determine the value of acoustic radiation force impulse（ARFI） in predicting the effect of neoadjuvant chemotherapy（NAC） in patients with breast cancer. Method 42 patients（42 lesions in all） with primary invasive breast cancer were included in the analysis. All patients underwent surgical resection after NAC. The change of elasticity before and after NAC was estimated by ARFI. Pathologic response of the tumors were assessed according to Miller-Payne（MP） histopatholgical grading system, in which grade I-III responses were histologically insignificant, while grade IV-V responses were of histological significance. On the premise of surgical pathology, the diagnostic performance of ARFI was evaluated using the receiver operating curve（ROC） analysis. Result For the 42 cases of breast cancer tissues, 69.05%（29/42） showed histologically significant response while 30.95%（13/42） were not otherwise. The diagnostic cutoff value of VTQ change was 29%（AUC=0.925, 95% CI： 0.863-0.987） for determining whether the neoadjuvant therapy was effective by using the ROC curve, with a sensitivity of 91.1%, specificity of 83.3%, and accuracy of 87.7%.After the NAC, there was significant decrease for VTQ value（P〈0.01） in those with histologically significant responses.Conclusion ARFI is applicable in quantitatively detecting the change of elasticity of breast cancer before and after neoadjuvant therapy, and is clinically relevant.

关 键 词：乳腺癌 声脉冲辐射力成像技术 新辅助化疗 疗效 

分 类 号：R737.9[医药卫生—肿瘤]