MRI在三阴性乳腺癌新辅助化疗疗效评价中的研究进展

Research progress of MRI in the evaluation of neoadjuvant chemotherapy efficacy for triple-negative breast cancer

三阴性乳腺癌(triple-negative breast cancer, TNBC)是一种具有高度异质性及侵袭性的乳腺癌亚型,并且由于缺乏有效的治疗靶点,对内分泌治疗及靶向治疗均不敏感,预后较差。目前新辅助化疗(neoadjuvant chemotherapy, NAC)是其标准治疗策略之一,但个体差异及肿瘤异质性使得不同患者的疗效差别较大,故早期准确客观评估NAC疗效对TNBC患者后续治疗的方案制订及预后判断尤为重要。磁共振成像(magnetic resonance imaging, MRI)因具有较高的软组织分辨率及定量成像技术,可准确反映肿瘤实质以及其微环境的变化,是目前监测肿瘤治疗疗效最常用的影像学检查方法之一。基于MRI的影像组学能够深度挖掘NAC前后TNBC的影像特征,获取更全面的肿瘤信息并应用于NAC疗效的评价。近年来,国内外研究人员就影像组学在TNBC NAC疗效评价方面进行了大量探索。本文就MRI及影像组学在TNBC患者NAC疗效评价的临床应用及研究进展做一综述,旨在为TNBC精准化和个体化治疗策略的制订提供参考。

Triple-negative breast cancer(TNBC)is a subtype of breast cancer characterized by high heterogeneity and aggressiveness.Because of the absence of effective therapeutic targets,TNBC is insensitive to endocrine therapy and targeted therapy,resulting in a poor prognosis.Currently,neoadjuvant chemotherapy(NAC)is one of the standard treatment strategies for TNBC.Given the individual variances and tumor heterogeneity,TNBC patients'response to NAC varies significantly,leading to diverse treatment outcomes.Therefore,early and accurate assessment of NAC efficacy is crucial for formulating subsequent treatment plans and predicting prognosis for TNBC patients.Magnetic resonance imaging(MRI)is widely utilized for monitoring the effectiveness of tumor treatment due to its high resolution for soft tissue and quantitative imaging technology,enabling accurate depiction of changes in tumor parenchyma and its microenvironment.MRI-based radiomics can deeply explore the imaging characteristics of TNBC before and after NAC,providing more comprehensive tumor information for evaluating NAC efficacy.In recent years,researchers both domestically and internationally have conducted extensive studies on the evaluation of NAC efficacy in TNBC using radiomics.This article aims to review the clinical applications and research advancements of MRI in assessing the efficacy of NAC in TNBC patients,with the goal of providing insights for developing precise and personalized treatment approaches for these patients.