彩色多普勒超声在乳腺癌患者新辅助化疗疗效评估中的应用价值

Value of Color Doppler Ultrasound in Evaluating the Curative Effect of Neoadjuvant Chemotherapy in Patients with Breast Cancer

【目的】探讨彩色多普勒超声在乳腺癌患者新辅助化疗疗效评估中的应用价值。【方法】200例行新辅助化疗患者化疗前后均接受彩色多普勒超声检查，比较不同疗效患者治疗前后肿瘤体积、二维超声表现、病灶血流分级、阻力指数（RI）情况。【结果】彩超评价有效130例，无效70例，以病理结果为金标准，彩超评价新辅助化疗敏感度、特异度、准确度分别为85．29％（87／102）、57．89％（55／98）、71．00％（142／200）。有效组化疗后肿瘤体积显著小于同组化疗前和无效组化疗后（P〈0．05）；与化疗前比较，部分缓解（PR）组化疗后边界清晰、形态规则、内部回声清楚、后方回声正常率均显著上升，血流丰富率、RI值显著下降（P〈0．05），而无效组化疗前后上述指标比较差异均无统计学意义（P〉o．05）。【结论】彩色多普勒超声通过二维超声表现、血流信号等对乳腺癌新辅助化疗疗效可做出客观、有效地评价。

[Objective]To evaluate the value of color Doppler ultrasound （CDU） in evaluating the curative effect of neoadjuvant chemotherapy in patients with breast cancer. [Methods] A total of 200 patients were exam- ined with CDU before and after＂ neoadjuvant chemotherapy. The tumor volume, two-dimensional ultrasonic find- ings, blood flow grade of lesions and resistance index （RI） were compared between patients with different curative effect. [Results] CDU showed CR＋PR in 130 cases and SD＋PD in 70 cases. With the pathological results as the gold standard, the sensitivity and accuracy of CDU in evaluating the curative effect of neoadjuvant chemotherapy were 85.29% and 71.00%, respectively. The tumor volume of CR＋PR group was significantly smaller than that of the same group before chemotherapy and SD＋PD group after chemotherapy （ P 〈0.05）. After chemotherapy, rates of clear boundary, regular shape, clear internal echo and normal rear echo in the PR group were significantly higher while rate of rich blood flow and RI value were significantly lower than those before chemotherapy（ P〈 0.05）. There was no significant differences of above indexes in the SD＋PD group before and after chemotherapy （ P 〉0.05）. [Conclusion] CDU can be used to objectively and effectively evaluate the curative effect of chemother- apy in treatment of breast cancer through two-dimensional ultrasonic findings and blood flow signals.