摘要
目的探讨常规超声(US)检查结合超声造影(CEUS)定量参数在三阴性乳腺癌(TNBC)患者新辅助化疗(NAC)早期疗效评估中的价值。方法选取女性TNBC患者28例(30个病灶),依据术后病理MP分级分为有效组和无效组,于NAC前及治疗2个周期后行US和CEUS检查。根据US检查获得的病灶最大径(MD),计算NAC前后病灶MD的差值(d_(1))及MD的变化率(d_(1)%);根据CEUS检查获得的病灶定量参数[包括造影剂到达病灶的时间(AT)、达峰时间(TTP)、峰值强度(PI)、曲线下面积(AUC)]和病灶MD,计算NAC前后病灶定量参数的差值(参数Δ)及定量参数的变化率(参数Δ%)、病灶MD的差值(d_(2))及MD的变化率(d_(2)%)。以治疗后病灶MD的变化情况作为实体肿瘤反应评价标准的指标,将NAC疗效分为有效和无效,采用Kappa检验评价其与术后病理MP分级结果的一致性。绘制ROC曲线,分析US和CEUS检查单独及联合评估NAC疗效的效能。结果CEUS检查对NAC疗效的评估结果与病理MP分级评估结果的一致性(Kappa=0.661)高于US检查评估结果与病理MP分级评估结果的一致性(Kappa=0.541)。两组d_(1)、d_(1)%、d_(2)%、AUC_(Δ)、AUC_(Δ)%比较差异均有统计学意义(P均<0.05)。US检查联合CEUS定量参数评估TNBC患者NAC早期疗效的AUC为0.976,灵敏度为94.7%,特异度为90.9%,优于两种检查单独评估。结论常规US检查联合CEUS定量参数对评估TNBC患者NAC早期疗效具有较高的临床价值。
Objective To investigate the value of routine ultrasound(US)examination combined with quantitative parameters of contrast enhenced ultrasound(CEUS)in the early efficacy assessment of neoadjuvant chemotherapy(NAC)in patients with triple-negative breast cancer(TNBC).Methods Twenty-eight female TNBC patients(30 lesions)were selected and divided into effective and ineffective groups based on postoperative pathologic MP grading,and US and CEUS examinations were performed before NAC and after 2 cycles of treatment.Based on the MD of the lesion obtained from the US examination,the difference in the MD of the lesion before and after NAC(d_(1))and the rate of change in MD(d_(1)%)were calculated;Based on the quantitative parameters of the lesion obtained from the CEUS examination including the time of arrival of the contrast agent to the lesion(AT),the time to peak(TTP),the peak intensity(PI),the area under the curve(AUC),and the MD of the lesion,the difference of the quantitative parameters of the lesion before and after the NAC(parameter Δ)and the rate of change of the quantitative parameters(parameter Δ%),and the difference of the MD of the lesion(d_(2))and the rate of change of the MD(d_(2)%)were calculated.The change in the MD of the lesion after treatment was used as an indicator for the evaluation criteria of solid tumor response,and the efficacy of NAC was classified as being effective and ineffective,and the Kappa test was used to evaluate its consistency with the results of postoperative pathological MP grading.The efficacy of US and CEUS tests alone and in combination to assess NAC efficacy was analyzed by ROC curves.Results The concordance between the results of CEUS examination assessment of NAC efficacy and the results of pathologic MP grading(Kappa=0.661)was higher than the concordance between the re‐sults of US examination assessment and the results of pathologic MP grading(Kappa=0.541).The difference between d_(1),d_(1)%,d_(2)%,AUCΔ,and AUCΔ%was statistically significant when comparing the two groups(all P<0.05).The AUC of the US test com‐bined with CEUS quantitative parameters to assess the early efficacy of NAC in TNBC patients was 0.976,with a sensitivity of 94.7%and a specificity of 90.9%,which was superior to the two tests alone.Conclusion Routine ultrasonography combined with quantitative parameters of contrast enhenced ultrasound has high clinical value in assessing the early outcome of NAC in TNBC patients.
作者
郭梦圆
王金岩
GUO Mengyuan;WANG Jinyan(School of Clinical Medicine,Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040,China;Department of Ultrasound,Baotou Cancer Hospital,Baotou 014030,China)
出处
《医学影像学杂志》
2025年第10期92-96,共5页
Journal of Medical Imaging
基金
内蒙古公立医院科研联合基金科技项目(编号:2024GLLH0769)。
关键词
三阴性乳腺癌
新辅助化疗
超声检查
Triple negative breast cancer
Neoadjuvant chemotherapy
Conventional ultrasound examination
