组织弹性成像预测乳腺癌新辅助化疗效果的价值

Value of tissue elastography in the prediction of neoadjuvant chemotherapy in breast cancer

目的:探索实时组织弹性成像(RTE)预测乳腺癌新辅助化疗(NAC)疗效的价值。方法:选取本院接受NAC的乳腺癌患者60例,根据病理结果分为反应显著组47例和反应非显著组13例。记录并比较两组患者NAC前和NAC后1、2、4、6周病灶最大径和应变率比值(B/A值)。利用ROC曲线分析病灶B/A值预测NAC疗效的价值。结果:两组NAC后病灶均呈蜂窝状减小,弹性图像上蓝色逐渐减少,绿色逐渐增多。重复测量方差分析发现最大径和B/A值在NAC治疗的6周内均呈下降趋势,反应显著组病灶最大径和B/A值在NAC前后显著小于反应非显著组,反应显著组与反应非显著组的最大径和B/A值在NAC前后的变化存在交互作用,以上差异均有统计学意义(均P<0.05)。NAC 2周病灶ΔB/A值预测NAC疗效的AUC最大(0.944),最佳诊断点为5.64,其敏感度为92.31%,特异性为87.23%。结论:NAC 2周病灶ΔB/A对预测乳腺癌NAC疗效具有一定价值,有望应用于临床诊断。

Objective: To explore the value of real-time tissue elastography(RTE) in predicting the efficacy of neoadjuvant chemotherapy(NAC) in breast cancer. Methods: A total of 60 patients with breast cancer who received NAC in our hospital were recruited. According to the pathological results, 47 patients were included in the significant response group and 13 patients were in the non-significant response group. The maximum diameter and strain ratio(B/A ratio) of lesions before and after NAC for 1, 2, 4 and 6 weeks was recorded and compared. The ROC curve of the lesion diameter and strain rate ratio(B/A value) was used to predict the value of NAC efficacy. Results: The lesions in the two groups showed a honeycomb-like reduction after NAC. The blue color in the elastic image gradually decreased, and the green color gradually increased. Repeated measurement analysis of variance found that the maximum diameter and B/A value showed a downward trend within 6 weeks of NAC treatment. The maximum diameter and B/A value in the significant response group were significantly lower than the non-significant response group before and after the NAC. There was an interaction in the maximum diameter and B/A value between the significant response group and the non-significant response group. The above differences were statistically significant(all P<0.05). The AUC of ΔB/A value at 2 weeks of NAC was maximal(0.944), and the best diagnostic point was 5.64.The sensitivity was 92.31% and the specificity was 87.23%. Conclusion: ΔB/A value at 2 weeks of NAC has certain value in predicting the therapeutic effect of NAC in breast cancer, and it is expected to be applied in clinical diagnosis.