超声剪切波弹性参数联合免疫组化指标对乳腺癌新辅助化疗后病灶残留的评估意义  

The Significance of Ultrasonic Shear Wave Elasticity Parameters Combined with Immunohistochemical Indexes in the Evaluation of Residual Lesions After Neoadjuvant Chemotherapy for Breast Cancer

作　　者：张雪晶 李红玲[1] 刘建新 毛明锋 Zhang Xuejing;Li Hongling;Liu Jianxin;Mao Mingfeng(Department of Ultrasound Diagnosis,Wuhan Central Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院超声诊断科,武汉市430000

出　　处：《中国超声医学杂志》2024年第4期399-404,共6页Chinese Journal of Ultrasound in Medicine

摘　　要：目的观察超声剪切波弹性参数联合免疫组化指标对乳腺癌新辅助化疗(NAC)后病灶残留的评估意义。方法回顾性收集于医院行NAC的150例乳腺癌患者声触诊组织量化成像(VTIQ)技术、活检标本免疫组化检查资料及临床信息。依据Miller-Payne(MP)分级分为病理完全缓解(pCR)组、非pCR组。探讨乳腺癌患者NAC后病灶残留的独立影响因素。分析免疫组化指标与NAC前、第2个周期后剪切波速度最大值(SWVmax)变化率(ΔSWVmax)对NAC后病灶残留的预测意义。观察ΔSWVmax与免疫组化指标的相关性。结果150例患者经治疗达pCR 32例(21.33%),非pCR 118例(78.67%)。Spearman分析显示,乳腺癌患者SWVmax与孕激素受体(PR)、雌激素受体(ER)表达呈正相关(P<0.05)。多因素Logistic回归分析显示,NAC前PR、ER表达,NAC第2个周期后SWVmax为患者NAC后病灶残留的独立危险因素,NAC前人表皮生长因子受体2(HER2)、Ki-67表达,ΔSWVmax为独立保护因素(P<0.05)。受试者工作特征(ROC)曲线分析显示,NAC前PR、ER、HER2、Ki-67表达,ΔSWVmax均对患者NAC后病灶残留具有一定预测意义,联合预测时灵敏度为94.92%,特异度为96.88%。结论NAC前PR、ER、HER2、Ki-67表达,ΔSWVmax对乳腺癌NAC后病灶残留具有一定预测效力,联合预测价值更好,测定上述指标利于为识别NAC潜在受益者提供支持,促进个体化治疗。Objective To observe the significance of ultrasonic shear wave elasticity parameters combined with immunohistochemical indexes in the evaluation of residual lesions after neoadjuvant chemotherapy(NAC)for breast cancer.Methods The data of virtual touch tissue imaging quantification(VTIQ),immunohistochemical examination of biopsy specimens and clinical information of 150 patients with breast cancer who underwent NAC were retrospectively collected.According to Miller-Payne(MP)classification,the patients were divided into pathological complete remission(pCR)group and non-pCR group.To explore the independent influencing factors of residual lesions after NAC in breast cancer patients.The predictive significance of immunohistochemical indexes and the change rate of maximum shear wave velocity(SWVmax)before and after the second cycle of NAC(ΔSWVmax)for residual lesions after NAC was analyzed.The correlation betweenΔSWVmax and immunohistochemical indexes was observed.Results Of the 150 patients,32(21.33%)achieved pCR and 118(78.67%)achieved non-pCR.Spearman analysis showed that SWVmax was positively correlated with the expression of progesterone receptor(PR)and estrogen receptor(ER)in breast cancer patients(P<0.05).Multivariate Logistic regression analysis showed that PR,ER expression before NAC,and SWVmax after the second cycle of NAC were independent risk factors for residual lesions after NAC,human epidermal growth factor receptor-2(HER2),Ki-67 expression before NAC,andΔSWVmax were independent protective factors(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that PR,ER,HER2,Ki-67 expression before NAC andΔSWVmax had certain predictive significance for residual lesions after NAC.The sensitivity and specificity of combined prediction were 94.92%and 96.88%,respectively.Conclusions The expression of PR,ER,HER2,Ki-67 before NAC andΔSWVmax have a certain predictive effect on the residual lesions of breast cancer after NAC,and the combined predictive value is better.The determination of the above ind

关 键 词：超声剪切波弹性参数 免疫组化指标 乳腺癌 新辅助化疗 病灶残留 预测价值 

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]