青岛大学学报（医学版）2023，Vol.59Issue(6)：840-844,5.DOI:10.11712/jms.2096-5532.2023.59.175
乳癌新辅助化疗DCE-MRI预测病理完全缓解的应用价值
APPLICATION OF DYNAMIC CONTRAST-ENHANCED MAGNETIC RESONANCE IMAGING IN PREDICTION OF PATHOLOGI-CAL COMPLETE RESPONSE OF BREAST CANCER TREATED BY NEOADJUVANT CHEMOTHERAPY
摘要
Abstract
Objective To evaluate the application of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in prediction of pathological complete response(pCR)in breast cancer patients treated with neoadjuvant chemotherapy(NAC).Methods A retrospective analysis was performed in 108 breast cancer patients who received NAC in our hospital from January 2020 to October 2022.DCE-MRI examination was performed before and after 2-3 cycles of NAC.The patients were divided into pCR group(36 patients)and non-pCR group(72 patients)according to the postoperative Miller-Payne pathological response gra-ding.The clinicopathological data and imaging characteristics were compared between the two groups.Multivariate logistic regres-sion was used to screen for independent influencing factors for predicting pCR and a prediction model was constructed.The area un-der receiver operating characteristic curve(AUC)was used to assess the efficacy of the model in pCR prediction.Results Statis-tically significant differences were found between the pCR and non-pCR groups in estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2(HER2),histological grading,tumor intensification mode,tumor regression mode,and maxi-mum tumor diameter change(△D%)(χ2 =-3.12 to 29.79,t=6.09,P<0.05).The multivariate logistic regression analysis showed that △D%(OR=1.046,95%CI=1.019-1.075,P<0.001)and HER2 expression(OR=0.171,95%CI=0.038-0.758,P=0.020)were independent predictors of pCR.The AUC was higher for △D%(0.813)than for HER2 expression(0.660),and their combination had the highest AUC value of 0.854,with a sensitivity of 80.6%and a specificity of 80.6%.Conclusion The△D%and HER2 expression in DCE-MRI are important parameters in pCR prediction at the early stage of NAC for breast cancer,which can provide an important basis for clinical treatment planning.关键词
乳腺肿瘤/化学疗法,辅助/磁共振成像/预测/病理完全缓解Key words
breast neoplasms/chemotherapy,adjuvant/magnetic resonance imaging/forecasting/pathologic complete response分类
医药卫生引用本文复制引用
张琦,林青,王海波,崔春晓,边甜甜,苏晓慧..乳癌新辅助化疗DCE-MRI预测病理完全缓解的应用价值[J].青岛大学学报（医学版）,2023,59(6):840-844,5.基金项目
国家重点研发计划课题(2016YFC1303004) （2016YFC1303004）
