超声造影预测乳腺癌新辅助化疗疗效分析

Prediction efficacy of neoadjuvant chemotherapy in the treatment of breast cancer with contrast-enhanced ultrasound

目的探讨超声造影参数预测乳腺癌新辅助化疗疗效的应用价值。方法 56例乳腺癌患者分别于新辅助化疗前及第2次化疗结束后进行超声造影检查。记录超声造影参数及4-6个周期新辅助化疗后的病理学疗效,比较新辅助化疗前、后超声造影参数的差异及不同病理学疗效分组间超声造影参数的差异。结果 56例乳腺癌病灶经新辅助化疗2个周期后的超声造影峰值强度（17.82±3.29 db）低于化疗前（23.80±3.74 db）,差异有统计学意义（t=19.948,P〈0.001）。化疗前、后两次乳腺癌病灶超声造影峰值强度变化率与病理反应分级呈正相关（spearman r=0.839,P〈0.001）。4-6个周期新辅助化疗后的病理有效组与无效组的峰值强度变化率分别为0.28±0.07和0.16±0.04（t=5.27,P=0.026）。结论超声造影参数中峰值强度变化率有助于预测乳腺癌新辅助化疗的疗效。

Objective To predict the efficacy of neo- adjuvant chemotherapy（ NAC） in the treatment of breast cancer with the parameters of contrast- enhanced Ultrasound（ CEUS）. Methods Fifty- six patients with breast cancer accepted CEUS examination respectively before and after two cycles NAC. Parameters of CEUS and Tumor Response Grade（ TRG） after mastectomy of all cases after 4 - 6 cycles NAC were recorded. Parameters of CEUS before and after NAC were compared,and the parameters between different pathologic effect groups were analyzed. Results Peak intensity of 56 cases of breast cancer lesions before and after two cycles NAC during CEUS were（ 23. 80 ± 3. 74） db and（ 17. 82 ±3. 29） db,respectively. The difference was statistically significant（ t = 19. 948,P〈0. 001）. Change rate of peak intensity（ CROPI） after two cycles NAC of all lesions were positively correlated with TRG（ spearmanr = 0. 839,P〈0. 001）. The differences of CROPI between effectivegroup（ 0. 28 ± 0. 07） and ineffective group（ 0. 16 ± 0. 04） after mastectomy were significant（ t = 5. 27,P = 0. 026）. Conclusion Change rate of peak intensity of CEUS can predict the effect of neo- adjuvant chemotherapy for breast cancer.