多参数半定量超声评估乳腺癌新辅助化疗疗效的价值

Value of semi-quantitative evaluation of neoadjuvant chemotherapy response in breast cancer using multi-parametric ultrasound

目的探讨多参数半定量超声评价乳腺癌新辅助化疗(NAC)疗效的价值。方法选择2017年1月至2019年1月在安徽医科大学第一附属医院乳腺外科接受NAC治疗后手术的35例乳腺癌患者为研究对象,NAC前后行常规灰阶、彩色多普勒超声结合弹性成像超声检查,采用灰阶病灶大小变化评分、彩色多普勒评分及弹性评分系统评估NAC疗效。以术前和术后病理为参考标准。结果NAC后,病灶大小较NAC前缩小,彩色多普勒评分及弹性评分降低,差异有统计学意义(P<0.05)。多参数半定量超声评估NAC疗效的灵敏度、特异度分别为88.89%、87.50%,其受试者工作特征曲线下最大面积为0.953。多参数半定量超声评估结果与病理学分级存在负相关(r=-0.729,P<0.001)。结论多参数半定量超声可准确评估乳腺癌患者NAC后疗效。

Objective To explore the value of multi-parametric semi-quantitative ultrasound in evaluating the efficacy of neoadjuvant chemotherapy(NAC)for breast cancer patients.Methods Thirty-five breast cancer patients who underwent NAC treatment in the Breast Surgery Department of the First Affiliated Hospital of Anhui Medical University from January 2017 to January 2019 were selected.Before and after chemotherapy,conventional gray-scale ultrasound and color doppler ultrasound combined with multi-mode ultrasound examination of elastic imaging technology were performed.The multi-parameter semi-quantitative scoring system of color doppler score and elasticity score was used to evaluate the efficacy of neoadjuvant chemotherapy for breast cancer.Preoperative pathology and postoperative pathology were used as reference criteria.Results After NAC,the lesion size was smaller than before,and the color doppler flow imaging and ultrasound elastography scores were lower,with statistically significant differences(P<0.05).The sensitivity and specificity of multi-parameter semi-quantitative ultrasound in evaluating the efficacy of NAC was 88.89%,87.50%respectively,and the maximum area under curve was 0.953.There was a significant negative correlation between the results of multi-parameter semi-quantitative ultrasound evaluation and the pathological grading(r=-0.729).Conclusion Multi-parametric semi-quantitative ultrasound can accurately evaluate the condition improvement of breast cancer patients after neoadjuvant chemotherapy.