动态增强磁共振成像在乳腺癌新辅助内分泌治疗中的应用价值

The application value of dynamic contrast-enhanced magnetic resonance imaging in neoadjuvant endocrine therapy of breast cancer

目的:探讨动态增强磁共振成像(Dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)在乳腺癌新辅助内分泌治疗中的应用价值。方法:选择2017年9月至2021年3月在包头市肿瘤医院初始实施新辅助内分泌治疗并且行手术的乳腺癌患者为研究对象。以组织病理学为判断标准,分析DCE-MRI在乳腺癌新辅助内分泌治疗中的应用价值。DCE-MRI评价为临床完全缓解(complete remission,CR)和部分缓解(partial remission,PR)定义为临床有效,并计算临床有效率;组织病理学Miller-Payne病理反应分级G2~G5定义为病理学评价有效,并计算病理有效率。结果:32例符合入组标准患者中DCE-MRI评价临床有效率为75.0%,术后组织病理学评价有效率为78.1%。对比组织病理学疗效评价,DCE-MRI判断新辅助内分泌治疗疗效的灵敏度为88.0%,特异度为71.4%,误诊率为12.0%,漏诊率为28.6%。两种疗效判断方法相比,差异无统计学意义(P>0.05)。结论:DCE-MRI对评估乳腺癌患者新辅助内分泌治疗的疗效具有重要意义。

Objective:To explore the application value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in neoadjuvant endocrine therapy for breast cancer patients.Methods:Selected breast cancer patients who underwent neoadjuvant endocrine therapy and surgery from September 2017 to March 2021 in Baotou Tumor Hospital as the research objects.Efficacy evaluation includes breast DCE-MRI and histopathology.The DCE-MRI evaluation of clinical complete remission(CR)and partial remission(PR)is defined as clinically effective,and the clinical effective rate is calculated;the histopathological Miller-Payne pathological response grade 2~5 is defined as pathological evaluation effective,and Calculate the pathological efficiency.Results:Among the 32 patients who met the inclusion criteria,the clinical effective rate of DCE-MRI was 75.0%,and the effective rate of postoperative histopathological evaluation was 78.1%.Compared with histopathological efficacy evaluation,the sensitivity of DCE-MRI in judging the efficacy of neoadjuvant endocrine therapy was 88.0%,the specificity was 71.4%,the misdiagnosis rate was 12.0%,and the missed diagnosis rate was 28.6%.There was no significant difference between the two curative effect judgment methods(P>0.05).Conclusion:DCE-MRI is of great significance for evaluating the efficacy of neoadjuvant endocrine therapy in breast cancer patients.