彩色多普勒超声对乳腺癌新辅助化疗后病理完全缓解的预测价值  

Predictive value of color Doppler ultrasonography for pathological complete remission after neoadjuvant chemotherapy for breast cancer

作　　者：彭秀丽 PENG Xiuli(Department of Ultrasound Diagnosis and Treatment,Jinxiang County People's Hospital,Jining,Shandong 272200,China)

机构地区：[1]金乡县人民医院超声诊疗科,山东济宁272200

出　　处：《影像研究与医学应用》2025年第4期19-21,25,共4页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨彩色多普勒超声对乳腺癌新辅助化疗后病理完全缓解(PCR)的预测价值。方法:选取2020年2月—2023年11月金乡县人民医院收治的乳腺癌患者82例,均行新辅助化疗方案治疗,参照Miller-Payne病理反应分级分为PCR组(n=28)和non-PCR组(n=54),均行彩色多普勒超声检查,分析彩色多普勒超声对PCR的预测价值。结果:PCR组彩色多普勒超声征象中侧方声影占比高于non-PCR组,肿瘤最大径低于non-PCR组,差异有统计学意义(P<0.05);两组肿瘤形态、边界、边缘、后方回声衰减、晕圈、钙化灶比较,差异无统计学意义(P>0.05)。PCR组超声血流动参数收缩期峰值血流速度(PSV)、血流阻力指数(RI)水平均低于non-PCR组,差异有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析显示,彩色多普勒超声征象中侧方声影、肿瘤最大径、PSV、RI预测乳腺癌新辅助化疗后PCR的曲线下面积(AUC)(95%CI)分别为0.818(0.716~0.920)、0.883(0.804~0.961)、0.840(0.754~0.925)、0.863(0.768~0.959),灵敏度分别为0.815、0.833、0.778、0.889,特异度分别为0.822、0.821、0.786、0.821。结论:彩色多普勒超声可根据声像特征、血流动力学指标对乳腺癌新辅助化疗后效果进行评估,尤其是侧方声影、肿瘤最大径、PSV、RI对乳腺癌新辅助化疗后PCR均具有较高的预测价值。Objective To investigate the predictive value of color Doppler ultrasonography(CDUS)for pathological complete response(PCR)after neoadjuvant chemotherapy(NAC)in breast cancer.Methods A total of 82 breast cancer patients admitted to Jinxiang County People's Hospital between February 2020 and November 2023 were enrolled,all receiving NAC.Based on the Miller-Payne pathological response grading,patients were divided into the PCR group(n=28)and the non-PCR group(n=54).All patients underwent CDUS,and the predictive value of CDUS for PCR was analyzed.Results The PCR group exhibited a higher proportion of lateral shadow on CDUS compared to the non-PCR group,with a smaller maximum tumor diameter(P<0.05).There were no statistically significant differences between the two groups in tumor morphology,boundary,margin,posterior acoustic attenuation,halo,or calcifications(P>0.05).The PCR group had lower peak systolic velocity(PSV)and resistive index(RI)levels on CDUS compared to the non-PCR group(P<0.05).receiver operator characteristic(ROC)curve analysis showed that the area under the curve(AUC)(95%CI)for predicting PCR after NAC in breast cancer,based on lateral shadow,maximum tumor diameter,PSV,and RI,were 0.818(0.716-0.920),0.883(0.804-0.961),0.840(0.754-0.925),and 0.863(0.768-0.959),respectively,with sensitivities of 0.815,0.833,0.778,and 0.889,and specificities of 0.822,0.821,0.786,and 0.821.Conclusion CDUS can assess the efficacy of NAC in breast cancer based on sonographic features and hemodynamic parameters,with lateral shadow,maximum tumor diameter,PSV,and RI showing high predictive value for PCR after NAC in breast cancer.

关 键 词：乳腺癌 新辅助化疗 彩色多普勒超声 病理完全缓解 预测价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]