超声光散射成像技术预测乳腺癌新辅助化疗疗效的价值

Value of ultrasound-guided diffuse optical tomography in predicting breast cancer neoadjuvant chemotherapy

目的探讨超声光散射成像(US-DOT)技术预测乳腺癌新辅助化疗(NCT)疗效的价值。方法选取乳腺癌NCT患者58例(58个病灶),于化疗前后行US-DOT检查,获取肿瘤大小和血红蛋白浓度(HBT)。根据实体瘤临床疗效评估标准将病灶分为完全缓解组8例、部分缓解组33例、稳定组17例,分析NCT前后各组HBT与肿瘤最大径的变化情况。应用Pearson相关性分析法分析肿瘤HBT变化百分比(△HBT%)与肿瘤最大径变化百分比(△Size%)的相关性,绘制受试者工作特征(ROC)曲线分析△HBT%预测NCT有效的截断值,计算诊断效能。结果各组化疗后HBT和肿瘤最大径均低于化疗前,组内比较差异均有统计学意义(均P<0.001);各组化疗后△HBT%和△Size%组间比较差异均有统计学意义(均P<0.001)。Pearson相关性分析显示△HBT%与△Size%呈正相关(r=0.874,P<0.001);△HBT%预测NCT有效的截断值为22.9%,曲线下面积为0.872,其诊断敏感性、特异性、阳性预测值、阴性预测值、准确性分别为82.93%、76.47%、89.47%、65.00%、81.03%。结论 US-DOT可以通过监测肿瘤△HBT%来预测NCT疗效,在临床应用中具有较好价值。

Objective To investigate the value of ultrasound-guided diffuse optical tomography(US-DOT) in predicting the efficacy of neoadjuvant chemotherapy(NCT) for breast cancer.Methods Fifty-eight cases of breast cancer treated with NCT were enrolled.US-DOT was performed to obtain tumor size and hemoglobin concentration(HBT) at pre-first and post-last chemotherapy.According to the Response Evaluation Criteria in Solid Tumor standard,the lesions were divided into complete response group(n=8),partial response group(n=33) and stable disease group(n=17).The changes of HBT and tumor size before and after NCT in each group were analyzed.The relationship between HBT changes(△HBT%) and tumor size changes(△Size%) was analyzed by Pearson correlation.Receiver operating characteristic(ROC) curve was established to predict the optimal threshold of △ HBT% and its diagnostic efficacy for breast cancer neoadjuvant chemotherapy.Results The HBT and tumor size of the lesions after NCT were lower than those before NCT,and the differences were statistically significant(all P<0.001).After NCT,the differences of △HBT% and △Size% were statistically significant among the groups(all P<0.001).Pearson correlation analysis showed that △ HBT% was positively correlated with △Size%(r=0.874,P<0.001).Taking △HBT%was 22.9% as the optimal threshold to predict NCT efficacy,the area under the ROC curve was 0.872,and the sensitivity was 82.93%,specificity was 76.47%,positive predictive value was 89.47%,negative predictive value was 65.00%,and accuracy was 81.03%,respectively.Conclusion US-DOT can predict the efficacy of NCT for breast cancer by monitoring △HBT% and has higher value in clinical application.