基线ADC值对不同分子亚型乳腺癌新辅助化疗疗效的预测价值

Value of baseline apparent diffusion coefficient in predicting the response of neoadjuvant chemotherapy in different subtypes of breast cancer

目的:探究化疗前表观扩散系数(基线ADC值)对不同分子亚型乳腺癌新辅助化疗(NAC)疗效的预测价值。方法:69例经穿刺活检证实为乳腺癌的患者纳入本研究中,Luminal A型、Luminal B型、HER 2+型和三阴性乳腺癌(TNBC)的患者分别为19例、23例、14例和13例。所有患者经病理证实有24例达到病理完全缓解(CRp),45例为非病理完全缓解(NCRp)。分析基线ADC值和相对ADC值(rADC)在不同分子亚型乳腺癌之间及CRp组与NCRp组间的差异,并分析基线ADC和rADC预测病理反应的效能。结果:基线ADC值和rADC值在4种不同分子亚型乳腺癌间差异没有统计学意义(P>0.05)。基线ADC值在CRp组和NCRp组间差异无统计学意义(P>0.05)。基线rADC值在CRp组与NCRp组间差异有统计学意义且有预测病理反应的效能。各亚型乳腺癌的基线ADC在CRp组及NCRp组间差异均无统计学意义(P>0.05)。Luminal A和Luminal B的基线rADC值在CRp组和NCRp组间有差异(P<0.05),且具有预测相应亚型乳腺癌病理反应的效能(AUC>0.5)。结论:基线rADC值可以预测乳腺癌病灶是否达到CRp,且Luminal A和Luminal B的基线rADC值具有评估相应亚型乳腺癌病理反应的效能。

Objective：To evaluate the apparent diffusion coefficient before chemotherapy （baseline ADC） in predicting the response to neoadjuvant chemotherapy （NAC） in differrent subtypes of breast cancer. Methods： 69 patients with aspiration biopsy proven breast cancer were included in this study. The number of patients with sub-type LuminalA,LuminalB, HER2 and three negative breast cancer （TNBC） were 19,23,14 and 13 respectively. Totally 24 patients showed pathologic complete response （CRp） and 45 patients showed non-pathologic complete response （NCRp）. The differences of the baseline （ADC） value and the relative apparent diffusion coefficient （rADC） value between different subtypes of breast cancer and between CRp group and NCRp group were analyzed. The efficacy of predicting pathology response with baseline ADC and rADC values were analyzed as well. Results： No significant statistic differences was existed in ADC and rADC values of these four molecular subtypes of breast cancer （P〉0.05）. The baseline ADC value had no significant differences between CRp group and NCRp group （P〉0.05）. The baseline rADC value had a significant difference between CRp group and NCRp group （P〈0.05）, pathologic response could be predicted. The baseline ADC value had no significant difference in CRP and NCRp groups of the four breast cancer subtypes （P〉0.05）. The baseline rADC value had significant differences between CRp and NCRp groups in Lminal A and Luminal B （P〈0.05） ,which also had ability to predict the pathologic response （AUC〉0.5）. Conclusion： The baseline rADC value is helpful to predict whether the breast cancer focus could reach CRp, as well as the baseline rADC value of Luminal A and Luminal B had the ability to evaluate the corresponding pathologic response.