DCE-MRI定量数据预测乳腺癌新辅助化疗疗效的价值  

Predictive Value of DCE-MRI Quantitative Parameters for the Curative Effect of Neoadjuvant Chemotherapy in Breast Cancer

作　　者：杜丹[1] 刘兴家 刘银凤[3] 李京龙[1] DU Dan;LIU Xing-jia;LIU Yin-feng;LI Jing-long(Imaging Center,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei Province,China;Hebei Medical University,Shijiazhuang 050000,Hebei Province,China;Department of Breast Surgery,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei Province,China)

机构地区：[1]秦皇岛市第一医院影像中心,河北秦皇岛066000 [2]河北医科大学,河北石家庄050000 [3]秦皇岛市第一医院乳腺外科,河北秦皇岛066000

出　　处：《中国CT和MRI杂志》2025年第3期115-118,共4页Chinese Journal of CT and MRI

基　　金：秦皇岛市重点研发计划科技支撑项目(201805A050)。

摘　　要：目的分析动态增强磁共振成像(DCE-MRI)定量参数对乳腺癌患者经新辅助化疗的疗效的评估价值。方法选取2021年12月至2023年4月于本院行新辅助化疗治疗的乳腺癌患者102例,分别于化疗前、化疗后(2个周期)采用DCE-MRI检查,记录容量转移常数(Ktrans)、回流速率常数(Kep)、容积分数(Ve值)及表观扩散系数(ADC值)。根据疗效情况分为缓解组(n=54)和无效组(n=48),收集两组临床资料,多因素Logistic回归分析确定乳腺癌患者疗效的影响因素,并采用受试者特征曲线(ROC)曲线评估DCEMRI定量数据对疗效的预测价值。结果化疗后患者Ktrans、Kep、Ve水平均低于化疗前,ADC高于化疗前(P<0.05)。缓解组和无效组在肿瘤分期、淋巴结转移和化疗前Ktrans、Kep、Ve、ADC比较上有显著差异(P<0.05)。多因素Logistic回归分析显示,影响乳腺癌患者新辅助化疗疗效的独立危险因素有化疗前Ktrans、Kep、Ve水平升高,ADC水平降低及有淋巴结转移(OR=2.622、2.542、2.237、0.433、2.396,P均<0.05)。ROC曲线分析,化疗前Ktrans、Kep、Ve、ADC及其并联检测预测乳腺癌新辅助化疗疗效的AUC分别为0.868、0.797、0.760、0.764和0.956。结论乳腺癌患者在行新辅助化疗后可降低Ktrans、Kep、Ve水平,提高ADC值,临床可通过DCE-MRI定量参数对乳腺癌患者新辅助化疗疗效行有效预测。Objective To explore the predictive value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)quantitative parameters for the curative effect of neoadjuvant chemotherapy in breast cancer.Methods A total of 102 patients with breast cancer undergoing neoadjuvant chemotherapy in the hospital were enrolled as the research objects between December 2021 and April 2023.Before and after chemotherapy(2 cycles),all underwent DCE-MRI examination to measure and record volume transfer constant(Ktrans),reflux rate constant(Kep),fraction volume(Ve)and apparent diffusion coefficient(ADC).According to the curative effect after 2 chemotherapy cycles,patients were divided into remission group(54 cases)and ineffective group(48 cases).The clinical data were collected.The independent risk factors affecting the curative effect of neoadjuvant chemotherapy in breast cancer were analyzed by multivariate Logistic regression analysis,and the predictive value of DCE-MRI quantitative parameters for the curative effect was evaluated by receiver operating characteristic(ROC)curves.Results After chemotherapy,Ktrans,Kep and Ve were decreased,while ADC was increased(P<0.05).There were significant differences in tumor staging,lymph node metastasis,Ktrans,Kep,Ve and ADC before chemotherapy between remission group and ineffective group(P<0.05).The results of multivariate Logistic regression analysis showed that the independent risk factors affecting the efficacy of neoadjuvant chemotherapy in breast cancer patients were increased Ktrans,Kep,Ve levels,decreased ADC level and lymph node metastasis before chemotherapy(OR=2.622,2.542,2.237,0.433,2.396,P<0.05).ROC curves analysis showed that AUC values of Ktrans,Kep,Ve,ADC before chemotherapy and combined detection(parallel mode)for predicting the curative effect of neoadjuvant chemotherapy were 0.868,0.797,0.760,0.764 and 0.956,respectively.Conclusion Ktrans,Kep and Ve are decreased,and ADC is increased in patients with breast cancer after neoadjuvant chemotherapy.Clinically,DCE-MRI quantitat

关 键 词：动态增强磁共振成像 乳腺癌 新辅助化疗 疗效 危险因素 

分 类 号：R737.9[医药卫生—肿瘤]