兰州大学学报（医学版）2025，Vol.51Issue(10)：26-32,7.DOI:10.13885/j.issn.2097-681X.2025.10.005
多模态超声预测浸润性乳腺癌新辅助化疗疗效的价值研究
Value of multimodal ultrasound in prediction of neoadjuvant chemotherapy for invasive breast cancer
摘要
Abstract
Objective To explore the predictive value of multimodal ultrasound in assessing the efficacy of neoadjuvant chemotherapy(NAC)for patients with invasive breast cancer.Methods 58 patients with invasive breast cancer were selected who received NAC treatment and multimodal ultrasound examinations were performed on them respectively before NAC treatment and after 2 cycles of NAC treatment.According to the post-chemotherapy pathologies,patients were assigned into the positive or negative outcome groups.Then the differences in the maximum diameter value of the conventional ultrasound tumor section,the strain ratio value of strain elastography,the maximum elasticity value of shear wave elastography,and the quantitative parame-ters of ultrasound were compared between the two groups.In addition,the differences between before and after the independent predictive ultrasound parameters related to the efficacy of NAC were also screened out via constructing a logistic regression model to comprehensively evaluate the predictive capacity of multimod-al ultrasound on the efficacy of neoadjuvant chemotherapy for invasive breast cancer.Results 44 cases were in the effective group and 14 in the ineffective group.The MD,SR,Emax and PI of patients in the former were significantly lower than those in the latter,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that PI(T1)was an independent ultrasound parameter for predicting the efficacy of NAC,and plotting the receiver operating characteristic(ROC)curve for predicting the efficacy of NAC with PI showed that the area under the curve(AUC)value of PI for predicting the efficacy of NAC in breast cancer patients was 0.966(0.927,1.000).In determining the efficacy of NAC,conventional ultrasound and elastography showed a poor agreement with pathologic findings(Kappa values=0.320,0.397),with AUC values of 0.640(0.527,0.753)and 0.732(0.632,0.832),respectively;ultrasonography showed a fair agree-ment(Kappa value=0.425),with an AUC value of 0.744(0.647,0.841);multimodal ultrasound indices showed a strong agreement with pathologic findings(Kappa value=0.781),and the AUC value was 0.919(0.853,0.985).Conclusion Multimodal ultrasound results showed great accordance with the pathologies in term of therapeutical outcomes among breast cancer patients treated with NAC.PI is an independent parame-ter for predicting the efficacy of NAC,and can be used as a noninvasive predictor of the efficacy of NAC.关键词
乳腺癌/新辅助化疗/多模态超声/弹性成像/超声造影Key words
breast cancer/neoadjuvant chemotherapy/multimodal ultrasound/elastography/contrast-en-hanced ultrasound分类
医药卫生引用本文复制引用
范琳琳,李雨涵,尹明..多模态超声预测浸润性乳腺癌新辅助化疗疗效的价值研究[J].兰州大学学报（医学版）,2025,51(10):26-32,7.基金项目
国家青年科学基金培育资助项目(TZKY20220105) （TZKY20220105）
