彩色多普勒超声在评价乳腺癌新辅助化疗效果中的应用价值

The Application Value of Color Doppler Ultrasound on Effect Evaluation of Neoadjuvant Chemotherapy in Breast Cancer

目的:探讨彩色多普勒超声在评价乳腺癌新辅助化疗(NAC)效果中的应用价值。方法:回顾性分析北京市顺义区妇幼保健院乳腺中心2010年1月-2015年12月收治的188例行新辅助化疗的原发性乳腺癌患者的临床资料,包括首诊超声检查/超声引导下空芯针穿刺活检病理诊断及新辅助化疗期间超声监测资料。采用Kappa检验对超声和病理诊断评价的一致性进行分析。结果:超声评价有效率为74.5%(140/188),病理评价有效率为93.6%(176/188),以病理诊断为金标准,超声评价有效率偏低,Kappa值为0.295。M&P评价1~5级患者中,超声检查和病理诊断评价符合率分别为91.7%、66.7%、66.7%、80.4%和98.0%。超声评价准确性在M&P分级2~4级患者中略差,而在1级和5级患者中较好。结论:彩色多普勒超声检查在新辅助化疗效果评价方面具有一定作用,能够为临床医师评判化疗效果提供依据,但是单纯使用超声测量肿物最大径线的方法对新辅助化疗效果进行评估可能不够全面。

Objective:To investigate the application value of color doppler ultrasound on effect evaluation of neoadjuvant chemotherapy(NAC)in breast cancer.Method:A total of 188 patients with primary breast cancer patients who underwent neoadjuvant chemotherapy(NAC)at the breast center in Shunyi Maternal and Children’s Health Care Hospital of Beijing from January 2010 to December 2012 were enrolled,and the imaging,clinical and pathological data were analyzed.Kappa test was used to analyze the consistency of ultrasonography and pathological diagnosis on effect evaluation of NAC.Result:The effective rate of ultrasound evaluation was 74.5%(140/188),and the effective rate of pathological evaluation was 93.6%(176/188).According to the gold standard of pathological diagnosis,the effective rate of ultrasound evaluation was lower,Kappa value was 0.295.The coincidence rates of ultrasound examination and pathological diagnosis were 91.7%,66.7%,66.7%,80.4%and 98.0%,respectively.The accuracy of ultrasound evaluation was slightly worse in patients with M&P grade 2 to grade 4,but better in grade 1 and grade 5.Conclusion:Color doppler ultrasound plays a potential role in effect evaluation of NAC,and could provide basis for clinicians.Thus,simply measuring the maximum radial line of the tumor by ultrasonography to evaluate the effect of NAC may be incomprehensive.