摘要
目的探讨超声术前评价新辅助化疗后乳腺癌残存病变病理反应状态的价值。资料与方法 60例新辅助化疗结束后行术前超声检查的乳腺癌患者,参考Miller&Payne反应性分级将患者的病理反应性分为5级,5级为病理完全缓解,其余为浸润癌残余,4级和5级为组织学显著反应,并以此作为"金标准",评估超声检查结果的敏感性、特异性、准确性、阳性预测值及阴性预测值。结果术前超声测量残余癌最大直径与病理测得残余癌最大直径呈显著正相关(r=0.7797,P<0.01)。超声对化疗后浸润癌残余判断的敏感性为92.3%,特异性为50.0%,准确性为86.7%,阳性预测值为92.3%,阴性预测值为50.0%;超声对化疗后组织学显著反应判断的敏感性为86.7%,特异性为84.4%,准确性为85.0%,阳性预测值为81.2%,阴性预测值为86.4%。结论超声对于乳腺癌新辅助化疗后浸润癌残余和组织学显著反应的评价有较高的敏感性和准确性,有助于新辅助化疗后术前无创性评价乳腺癌的病理反应性。
Purpose To investigate the clinical value of ultrasonography（US） in assessing pathologic responses in breast cancer treated with neoadjuvant chemotherapy（NCT）.Materials and Methods Sixty patients with pathologyconfirmed breast cancer finished last course of NCT underwent preoperative breast US examination.Pathologic response was assessed according to Miller Payne five-point classification,of which grade 5 defined as pathological complete response（pCR）,and grade 5 or 4 defined as major histological response（MHR）.All US findings were compared with postoperative pathological results,and the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of US were also calculated.Results Correlation of pathology and preoperative US as measured by the longest diameter of residual tumor was excellent（r = 0.7797,P 〈0.01）.For detecting pathologically invasive（pINV） residual disease,US had sensitivity of 92.3%,specificity of 50.0%,accuracy of 86.7%,positive predictive value of 92.3% and negative predictive value of 50.0%,while MHR evaluation had sensitivity of 86.7%,specificity of 84.4%,accuracy of 85.0%,positive predictive value of 81.2% and negative predictive value of 86.4%,respectively.Conclusion Ultrasonography is sensitive and accurate in detecting residual breast cancer after NCT,and can be used to predict postoperative pathologic response.
出处
《中国医学影像学杂志》
CSCD
北大核心
2012年第7期533-535,539,共4页
Chinese Journal of Medical Imaging
基金
北京市自然科学基金资助项目(7112100)
关键词
乳腺肿瘤
超声检查
乳房
新辅助化疗
病理学
外科
Breast neoplasms
Ultrasonography
mammary
Neoadjuvant therapy
Pathology
surgical
