超声联合免疫组织化学指标预测新辅助化疗后乳腺癌转移性腋窝淋巴结病理完全缓解  

Ultrasound combined with immunohistochemical indexes for predicting pathological complete response of metastatic axillary lymph nodes of breast cancer after neoadjuvant chemotherapy

作　　者：苏泽珍 李蔓英[1] 黄彩欣 罗佳[1] 梁瑾瑜[1] 潘福顺[1] 郑艳玲[1] 谢晓燕[1] SU Zezhen;LI Manying;HUANG Caixin;LUO Jia;LIANG Jinyu;PAN Fushun;ZHENG Yanling;XIE Xiaoyan(Department of Medical Ultrasonic,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China;Department of Medical Ultrasonic,Zhujiang Hospital of Southern Medical University,Guangzhou 510280,China)

机构地区：[1]中山大学附属第一医院超声医学科,广东广州510080 [2]南方医科大学珠江医院超声医学科,广东广州510280

出　　处：《中国医学影像技术》2022年第3期379-383,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的 观察超声联合免疫组织化学指标预测新辅助化疗(NACT)后乳腺癌转移性腋窝淋巴结病理完全缓解(pCR)的价值。方法 纳入155例接受NACT的乳腺癌伴腋窝淋巴结转移患者,根据腋窝淋巴结清扫(ALND)术后病理结果将其分为pCR组(n=59)及非pCR组(n=96);比较2组NACT前免疫组织化学指标及乳腺癌病灶及腋窝淋巴结的超声特征,建立logistic预测模型,观察其预测NACT后腋窝淋巴结pCR的价值。结果 2组乳腺癌原发灶Ki-67表达、人表皮生长因子受体2(HER-2)表达及腋窝转移性淋巴结短径、最大皮质厚度和形态差异均有统计学意义(P均<0.05)。logistic预测模型预测NACT后乳腺癌腋窝转移性淋巴结pCR的AUC为0.734,敏感度为42.37%(25/59),特异度为84.38%(81/96)。结论 NACT前超声联合免疫组织化学预测NACT后乳腺癌转移性腋窝淋巴结pCR具有一定价值。Objective To observe the value of ultrasound combined with immunohistochemical indexes for predicting pathological complete response(pCR) of metastatic axillary lymph nodes of breast cancer after neoadjuvant chemotherapy(NACT). Methods Totally 155 breast cancer patients with axillary lymph node metastasis who then underwent NACT were enrolled and divided into pCR group(n=59) and non-pCR group(n=96) according to the pathological results after axillary lymph node dissection(ALND). The immunohistochemical indexes and ultrasonic characteristics of primary breast cancer and metastatic axillary lymph nodes before NACT were compared between groups. Then logistic prediction model was established, and its value for predicting metastatic axillary lymph node pCR after NACT was observed. Results There were significant differences of Ki-67, human epidermal growth factor receptor-2(HER-2) of primary breast cancer, as well as the short diameter, the maximum cortical thickness and the morphologies of metastatic axillary lymph nodes between groups(all P<0.05). The area under the curve(AUC), the sensitivity and specificity of logistic prediction model for predicting pCR of metastatic axillary lymph nodes after NACT were 0.734, 42.37%(25/59) and 84.38%(81/96), respectively. Conclusion Ultrasound combined with immunohistochemistry before NACT had certain value for predicting pCR of metastatic axillary lymph nodes of breast cancer after NACT.

关 键 词：乳腺肿瘤 淋巴结转移 新辅助治疗 病理完全缓解 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]