DCE-MRI联合DWI评估乳腺癌新辅助化疗疗效方面的研究进展

Research Progress of DCE-MRI Combined with DWI in Evaluating the Efficacy of Neo-adjuvant Chemotherapy for Breast Cancer

据世界卫生组织最新发布的研究表明,乳腺癌的发生率已经超过肺癌,成为全球第一大恶性肿瘤,我国乳腺癌的病例数量上升至每年约42万人,并且近年来发病率每年递增3%~4%,但乳腺癌并非是一种不治之症,新辅助化疗(Neoadjuvant Chemotherapy, NAC)是一种全身化疗,包括在手术消融前对病变进行局部放疗,它在一定程度上降低了癌细胞转移的风险,并尽可能缩小病灶,这有助于后续的手术干预来控制患者的病情,从而防止其持续进展。因此越早检测出乳腺肿瘤,延长患者生存周期的几率越大。既往研究表明,NAC后达到病理完全缓解(pCR)的患者比非Pcr (部分缓解或无缓解)的患者显著延长了总生存期(OS)和无病生存期(DFS)。随着技术的逐步发展,弥散加权成像DWI (diffusion weighted imaging, DWI)和动态对比增强(Dynamic Contrast-Enhanced Magnetic Reso-nance Imaging, DCE-MRI)等功能性磁共振成像(magnetic resonance imaging, MRI)技术,也广泛用于乳腺疾病的诊断中。本篇综述主要探讨DCE-MRI联合DWI评价新辅助化疗在评估乳腺癌新辅助化疗疗效方面的研究进展。

According to the latest research released by the World Health Organization, the incidence of breast cancer has exceeded lung cancer, becoming the world’s largest malignant tumor, about 420,000 new patients with breast cancer in China every year, and in recent years, the incidence of annual increase of 3%~4%, but breast cancer is not an incurable disease. Neoadjuvant Chemotherapy (NAC) refers to systemic chemotherapy with local radiotherapy to the lesion before surgical resec-tion, which to some extent reduces the risk of cancer cell metastasis, shrinks the lesion as much as possible, and facilitates subsequent surgical intervention to control the patient’s disease, thus pre-venting the disease from continuing to progress . Therefore, the earlier a breast tumor is detected, the greater the chance of prolonging a patient’s survival cycle. Previous studies have shown that pa-tients who achieve pathologically complete response (pCR) after NAC have significantly longer over-all survival (OS) and disease-free survival (DFS) than patients who do not have a pCR (partial re-sponse or no response). With the gradual development of the technology, diffusion weighted imag-ing (DWI) and Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI), Functional magnetic resonance imaging (MRI) techniques, such as DCE-MRI, are also widely used in the diag-nosis of breast diseases. This review focuses on the research progress of DCE-MRI combined with DWI in evaluating the efficacy of neoadjuvant chemotherapy for breast cancer.