治疗前T2WI水肿表现预测乳腺癌新辅助化疗疗效的价值

Value of edema on T2WI before treatment in predicting the efficacy of neoadjuvant chemotherapy for breast cancer

目的 探究T2WI乳腺水肿表现预测新辅助化疗(neoadjuvant chemotherapy, NAC)疗效的价值及其影响因素。材料与方法 回顾性分析2018年10月至2022年3月于宁夏医科大学总医院经免疫组化确诊为乳腺癌并接受NAC的患者资料。根据NAC前T2WI水肿表现对乳腺水肿评分(breast edema score, BES),无水肿、瘤周水肿、胸前水肿、皮下水肿分别定义为BES1、BES2、BES3、BES4,术后病理完全缓解(pathological complete response, pCR)作为NAC疗效评价标准。采用SPSS软件单因素分析BES及临床病理特征预测疗效的价值,进一步评估肿瘤直径、Ki-67、组织学分级、NAC方案、分子分型、腋窝淋巴结转移与BES的相关性。结果 本研究共分析260例患者资料,pCR率为40.4%(105/260)。单因素分析显示pCR组与非pCR组(Non-pCR组)BES、肿瘤直径、Ki-67、NAC方案、分子分型差异具有统计学意义(P<0.05);乳腺水肿影响因素分析显示BES与肿瘤直径、腋窝淋巴结转移相关(P<0.05),与肿瘤直径呈正相关(rs=0.442)。结论 BES有助于预测乳腺癌患者NAC的疗效,且与肿瘤直径、腋窝淋巴结转移相关;肿瘤直径、Ki-67、NAC方案、分子分型也是NAC疗效的有效预测因素。

Objective:To explore the predictive value of breast edema on T2WI before neoadjuvant chemotherapy(NAC)and breast edema's influencing factors.Materials and Methods:From October 2018 to March 2022,the data of patients with breast cancer diagnosed by immunohistochemical technique and treated with NAC in General Hospital of Ningxia Medical University were retrospectively collected.According to the breast edema score(BES)on T2WI before NAC,no edema,peritumoral edema,prechest edema,and subcutaneous edema were respectively defined as BES1,BES2,BES3,and BES4.Postoperative pathological complete response(pCR)was used as the evaluation standard for the efficacy of NAC.SPSS software was used for single factor analysis of BES and its clinicopathological characteristics to predict the efficacy.The correlation between BES and tumor diameter,Ki-67,histological grade,NAC schedule,molecular typing,axillary lymph node metastasis was further evaluated.Results:A total of 260 subjects were included,and the pCR rate was 40.4%(105/260).Univariate analysis showed that there were significant differences in BES,tumor diameter,Ki-67,NAC schedule and molecular typing between the pCR group and the Non-pCR group(P<0.05).Analysis of the influencing factors of breast edema showed that BES was correlated with tumor diameter and axillary lymph node metastasis(P<0.05),and was positively correlated with tumor diameter(rs=0.442).Conclusions:BES is helpful to predict the efficacy of NAC in breast cancer patients,and it is related to tumor diameter and axillary lymph node metastasis.Tumor diameter,Ki-67,NAC schedule and molecular typing were also effective predictors of NAC response.