超声弹性成像与三阴性乳腺癌患者新辅助化疗效果及预后的相关性分析  

The Correlation Between Ultrasound Elastography and the Effect and Prognosis of Neoadjuvant Chemotherapy in Patients with Triple Negative Breast Cancer

作　　者：缪娟[1] 陈泽华[2] Miao Juan;Chen Zehua(Department of Ultrasound,Zigong Fourth People’s Hospital,Zigong,Sichuan 643000,China;Department of General Surgery,The Second People’s Hospital of Zigong,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院超声科,四川省自贡市643000 [2]自贡市中医医院普外科,四川省自贡市643000

出　　处：《中国超声医学杂志》2024年第4期405-409,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探究超声弹性成像(UE)与三阴性乳腺癌(TNBC)患者新辅助化疗(NAC)效果、预后的相关性。方法选择经病理证实且接受NAC治疗的TNBC患者98例,NAC治疗前后均行常规超声及UE检查。观察NAC治疗前后病理完全缓解(pCR)与非pCR患者UE评分≥4分比例、最大弹性值(Emax)变化情况。受试者工作特征(ROC)曲线分析Emax对NAC治疗后pCR的预测效能,且经二元Logistic回归分析患者预后影响因素。结果TNBC患者NAC治疗4个周期后UE评分≥4分(76.53%vs.28.57%)、Emax[(204.30±51.28)vs.(109.62±26.47)]较治疗前均显著下降(P<0.05)。pCR组NAC治疗4个周期后UE评分≥4分比例显著低于非pCR组(P<0.05);两组治疗4个周期后Emax较治疗前均显著下降且pCR组显著低于非pCR组(P<0.05)。治疗后Emax联合预测TNBC患者NAC治疗后pCR的曲线下面积(AUC)为0.770,大于治疗前的0.700及治疗后的0.723。随访到2024年1月,随访期间病灶复发转移率为39.78%;Logistic回归分析显示临床分期Ⅲ期、NAC治疗前超声显示硬环征、高Emax水平、Ki-67阳性是影响TNBC患者预后的独立危险因素(P<0.05)。结论UE对TNBC患者NAC治疗效果预测、预后评估有一定的价值。Objective To explore the correlation between ultrasound elastography(UE)and the effect and prognosis of neoadjuvant chemotherapy(NAC)in patients with triple negative breast cancer(TNBC).Methods A total of 98 TNBC patients pathologically confirmed and received NAC were selected.Routine ultrasound and UE examination were performed before and after NAC treatment.The proportion of UE score≥4 points and maximum elastic modulus(Emax)changes of pathological complete response(pCR)and non-pCR patients were observed before and after NAC treatment.ROC curve was used to analyze the predictive efficiency of pCR after NAC treatment by Emax,and the factors influencing prognosis were analyzed by binary Logistic regression.Results After 4 cycles of NAC treatment,UE score≥4 points(76.53%vs.28.57%)and Emax[(204.30±51.28 vs.(109.62±26.47)]significantly decreased(P<0.05).The proportion of UE score≥4 points in pCR group was significantly lower(P<0.05);Emax in both groups was significantly lower after treatment,and that in pCR group was significantly lower(P<0.05).AUC of pCR in TNBC patients after NAC treatment predicted by Emax combination was 0.770,which was higher than 0.700 before and 0.723 after treatment.During the follow-up to January 2024,the recurrence and metastasis rate was 39.78%.Logistic regression analysis showed that clinical stageⅢ,ultrasonography showing hard ring sign before NAC treatment,high Emax level and positive Ki-67 were independent risk factors for the prognosis of TNBC patients(P<0.05).Conclusions UE has certain value in predicting NAC therapeutic effect and evaluating prognosis of TNBC patients.

关 键 词：三阴性乳腺癌 新辅助化疗 超声弹性成像 效果 预后 

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]