多参数磁共振成像对乳腺癌新辅助化疗效果的相关性分析

Correlation analysis of multi parameter magnetic resonance imaging in neoadjuvant chemotherapy for breast cancer

目的探讨肿瘤最大径、表观扩散系数(apparent diffusion coefficient,ADC)值及动态对比增强磁共振成像(dynamic contrast-enhancement magnetic resonance imaging,DCE-MRI)对乳腺癌新辅助化疗疗效中的评估价值。方法回顾分析榆林市星元医院2016年1月至2022年3月期间50例经手术后病理学检查证实的浸润性乳腺癌患者的临床资料,所有患者均行穿刺病理学证实且行新辅助化疗后手术切除。比较病理完全缓解组(pCR)和非病理完全缓解组(NpCR)患者磁共振成像参数的差异,并对有统计学意义的指标通过多因素Logisitic回归分析建立联合评估模型。最后对单独及联合评估效能进行受试者工作特征曲线(receiver operating characteristic curve,ROC)分析。结果肿瘤最大径线变化率和DCE-MRI最强强化率两组间具有显著差异,且单独及联合均具有显著的评估效能,而ADC值不具有显著差异。结论ADC值可评估新辅助化疗效果但有其局限性;肿瘤最大径线变化率与DCE-MRI最强强化率均可单独作为新辅助化疗疗效判断的指标,且二者联合评估效能会更加优越。

Objective To investigate the evaluation value of maximum tumor diameter,apparent diffusion coefficient(ADC)values and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the efficacy of neoadjuvant chemotherapy for breast cancer.Methods The study retrospectively analyzed the clinical data of 50 patients with surgically pathologically confirmed invasive breast cancer between January 2016 and March 2022 at Yulin Xingyuan Hospital,and all patients were confirmed by puncture pathology and surgically resected after neoadjuvant chemotherapy.The differences in magnetic resonance(MR)parameters between the pathological complete remission group(pCR)and the non-pathological complete remission group(NpCR)were compared,and the joint evaluation model was established by multivariate logistic regression analysis for the indicators with statistically significant differences.Finally,receiver operating characteristic curve(ROC)analysis was performed for the individual and combined evaluation efficacy.Results There were significant differences between the two groups in the rate of change in maximum tumor diameter and the rate of maximum enhancement on DCE-MRI,and both alone and in combination had significant evaluation value,while the ADC values did not have a significant difference.Conclusion ADC value can evaluate the efficacy of neoadjuvant chemotherapy,but it has its limitations.The maximum tumor diameter change rate and the strongest enhancement rate of DCE-MRI could be used alone as indicators for judging the efficacy of neoadjuvant chemotherapy,and the combined evaluation efficiency of the two would be more superior.