实时灰阶超声造影联合血清CEA、CA199水平检测评估高侵袭性乳腺癌新辅助化疗效果的临床价值  

Clinical Value of Real-time Gray Scale Contrast-enhanced Ultrasound Combined with Detection of Serum CEA,CA199 in Evaluating the Effect of Neoadjuvant Chemotherapy in Patients with High Invasive Breast Cancer

作　　者：张丽春[1] ZHANG Lichun(Zhongshan People＇s Hospital,Zhongshan 528400,Chin)

机构地区：[1]广东省中山市人民医院,广东中山528400

出　　处：《中国医学创新》2018年第14期83-87,共5页Medical Innovation of China

基　　金：中山市科技计划项目(B2018128)

摘　　要：目的:探讨实时灰阶超声造影(contrast-enhanced ultrasound,CEUS)联合血清CEA、CA199水平检测评估高侵袭性乳腺癌新辅助化疗(neoadjuvant chemotherapy,NAC)效果的临床价值。方法:选取2012年5月-2017年4月本院肿瘤科收治的80例高侵袭性乳腺癌患者作为研究对象。所有患者于化疗前后行CEUS检查及外周血CEA、CA199水平检测,比较化疗前行穿刺获取病理资料和化疗后的病理结果,根据病理反应性分级标准,评估化疗前后CEUS指标及外周血CEA、CA199水平变化。结果:化疗后,有效患者为39例,无效患者为41例。有效组高增强比例显著低于无效组,差异有统计学意义(P<0.05)。化疗前,有效组灌注缺损和放射状血管比例均显著低于无效组,差异均有统计学意义(P<0.05)。化疗后,有效组峰值强度、RBV及血流速度均显著低于无效组,而达峰时间明显长于无效组,差异均有统计学意义(P<0.05)。化疗后,CEA、CA199水平下降≥25%组的NAC有效率显著高于下降<25%组,差异有统计学意义(P<0.05)。结论:实时灰阶超声造影联合血清CEA、CA199水平检测评估高侵袭性乳腺癌新辅助化疗效果具有一定临床价值。Objective：To evaluate the clinical value of real-time gray-scale contrast-enhanced ultrasound combined with serum CEA,CA199 in evaluating neoadjuvant chemotherapeutic effects of highly invasive breast cancer.Method：A total of 80 patients with high invasive breast cancer in our hospital from May 2012 to April 2017 were selected.All patients were examined by CEUS and peripheral blood CEA and CA199 levels before and after chemotherapy.The pathological data obtained by puncture before and after chemotherapy were compared with the pathological results after chemotherapy.According to the criteria of pathological reactivity,the changes of CEUS and CEA,CA199 levels in peripheral blood were evaluated before and after chemotherapy.Result：After chemotherapy,39 cases were effective and 41 cases were ineffective.After chemotherapy,the enhancement ratios of cancer in the effective group was lower than that in the ineffective group（P〈0.05）.Before chemotherapy,the ratios of perfusion defect area and radialvessels in the effective group were lower than those in the ineffective group（P〈0.05）.After chemotherapy,the peak intensity,RBV and blood flow velocity in effective group were lower than those in the ineffective group（P〈0.05）,the time to peak in the effective group was higher than that in the ineffective group（P〈0.05）.After chemotherapy,the effective rate in the decline levels of CEA and CA199≥25% group was higher than that in the decline levels of CEA and CA19925% group（P〈0.05）.Conclusion：Real-time gray-scale contrast-enhanced ultrasound combined with serum CEA,CA199 level in the evaluation of neoadjuvant chemotherapeutic effect of highly invasive breast cancer has certain clinical value.

关 键 词：灰阶超声造影 CEA CA199 高侵袭性乳腺癌 新辅助化疗 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]