中国临床医学影像杂志2017，Vol.28Issue(11)：774-780,7.
ABVS对乳腺癌新辅助化疗疗效评价的应用价值
The application value of ABVS in evaluating the curative effect of neoadjuvant chemotherapy in patients with breast cancer
黄梅 1郑斌 1王树群 1冯娜娜 1许华 1孙建娜 1陈雯 1高峰 1宋红雨 1李静艳1
作者信息
- 1. 河北省沧州中西医结合医院,河北沧州 061001
- 折叠
摘要
Abstract
Objective:To estimate the relations between tumor's longest diameter,area,volume and their reduction rate after neoadjuvant chemotherapy (NACT) and pathological response classification in patients of locally advanced breast cancer,and then investigate the application value of automated breast volume scanner (ABVS) in evaluating the curative effect of NACT.Methods:A prospective study was undertaken in patients undergoing NACT for locally advanced breast cancer in order to determine the ability of quantitative ABVS to assess the final pathologic response.Eighty-one patients were divided into two groups based on pathological response.Pathological response was assessed according to Miller & Payne grading system,of which grade 4 and 5 defined as major histological response (MHR),and grade l to 3 as non-major histological response (NMHR).Eighty-one cases with pathologically confirmed locally advanced breast cancer who had been performed four courses of NACT underwent preoperative breast ABVS three times during the NACT.The results are analyzed with T test (or MannWhitney U test).Concordance correlation coefficient (CCC) was used to evaluate the agreement among above methods.Receiver operating characteristic curve (ROC) analysis was applied to assess the predictive value of tumor size and the reduction rate.Results:Before,after the second and the fourth cycle of NACT,there were statistical differences in tumor's longest diameters,areas and volumes among three measurements in MHR group(P＜0.05),so does NMHR group(P＜0.05).There were also statistical difference in tumor's longest diameters between MHR and NMHR (P＜0.05),while no difference in tumor's areas and volumes(P＞0.05).The differences between first and second measurements after NACT showed significantly statistical difference (P＜ 0.05).The reduction rate in MHR group was higher.The same results of reduction rate were found in inter-group between first and second measurements (P＜0.05).And the value of second measurement was higher,while the tendency was more obvious in MHR group.Base on reduction rate of their longest diameters,areas and volumes of two times,we take postoperative pathological response as golden standard to get the ROC curve and area under curve (AUC),the above indicators results of first measurement were as follows:0.696,0.693,0.723,the second measurements results were 0.807,0.824,0.858.But there were no statistical significance between them.Conclusion:To measure the lesion's longest diameters,areas and volumes of breast cancer patients with ABVS before and after NACT,we found their agreement are well.ABVS is valuable in evaluating the curative effect of neoadjuvant chemotherapy in patients with breast cancer.After NACT the assessment efficacy of the reduction rate of tumor's longest diameter,area and volume had significantly predicted effect on e~imating pathological reaction.关键词
乳腺肿瘤/超声检查,乳房Key words
Breast neoplasms/Ultrasonography, mammary分类
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黄梅,郑斌,王树群,冯娜娜,许华,孙建娜,陈雯,高峰,宋红雨,李静艳..ABVS对乳腺癌新辅助化疗疗效评价的应用价值[J].中国临床医学影像杂志,2017,28(11):774-780,7.
