自动乳腺全容积成像联合声辐射力脉冲弹性成像评价乳腺癌新辅助化疗的疗效-现代医学

自动乳腺全容积成像联合声辐射力脉冲弹性成像评价乳腺癌新辅助化疗的疗效

单位：复旦大学附属华山医院宝山分院超声科, 上海 200431

分类号：R445.1

出版年·卷·期（页码）：2021·49·第七期（751-755）

摘要：

目的：探讨自动乳腺全容积成像（ABVS）联合声辐射力脉冲弹性成像（ARFI）技术早期评价乳腺癌新辅助化疗（NACT）疗效的价值。方法：选取接受NACT的患者83例，于NACT前及NACT后1、2、4周期末均行ABVS及ARFI检查。以术后病理为标准，分为显著反应组和非显著反应组。测量两组病灶化疗前后病灶最大体积（V_max）、剪切波传播速度（SWV），比较两组化疗前和化疗后各周期病灶V_max缩小率（ΔV_max）及SWV缩小率（ΔSWV）。结果：显著反应组ΔV_max及ΔSWV各周期末均大于非显著反应组（P<0.05）。ΔV_max及ΔSWV随NACT周期的增加而逐渐增大（P<0.05）。单独指标评价NACT疗效的准确性低于联合指标。4周期末ΔV_max和ΔSWV联合评价的准确性最高，2周期末联合评价的准确性略低于4周期末，差异无统计学意义（P>0.05）。结论：ΔV_max及ΔSWV可早期评价乳腺癌患者NACT疗效，2周期末ΔV_max和ΔSWV联合对评价NACT疗效更有意义。

Objective: To investigate the value of automated breast volume scanner(ABVS) and acoustic radiation force impulse(ARFI) to early evaluate clinical efficacy of breast cancer neoadjuvant chemotherapy(NACT).Methods: 83 patients with breast cancer who underwent NACT were enrolled in this study. ABVS and ARFI were performed at baseline and after the end of 1,2,4 cycles of NACT. According to the postoperative pathological results, the lesions were divided into significant response group and non-significant response group. The maximum volume reduction rate (ΔV_max) and shear wave velocity reduction rate (ΔSWV) of the two groups of the lesions between the baseline and after the end of 1,2,4 cycles of NACT were compared. Results: The ΔV_max and ΔSWV of the significant response group was greater than those of the non-significant response group at the end of each cycle (P<0.05). The ΔV_max and ΔSWV gradually increased with the increase of the NACT cycle (P<0.05). The accuracies of the single index to evaluate the efficacy of NACT were lower than those of the combined index. The accuracy of the combined evaluation of ΔV_max and ΔSWV at the end of the 4th cycle was the highest, while the accuracy of the 2nd cycle was slightly lower than that at the end of the 4th cycle (P>0.05). Conclusions: The ΔV_max and ΔSWV in breast cancer lesions could early evaluate the efficacy of NACT. The combination of ΔV_max and ΔSWV at the end of cycle 2 has a greater significance in evaluating the efficacy of NACT.

参考文献：

[1] KAUFMANN M, VON MINCKWITZ G, BEAR H D, et al.Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer:new perspectives 2006[J].Ann Oncol, 2007, 18(12):1927-1934.
[2] CHEN A M, MERIC-BERNSTAM F, HUNT K K.Breast conservation after neoadjuvant chemotherapy:the M.D.Anderson Cancer Center Experience[J].J Clin Oncol, 2004, 22(12):2303-2312.
[3] LOO C E, STRAVER M E, RODENHUIS S, et al.Magnetic resonance imaging response monitoring of breast cancer during neoadjuvant chemotherapy:relevance of breast cancer subtype[J].J Clin Oncol, 2011, 29(6):660-666.
[4] CHO N, IM S A, PARK I A, et al.Breast cancer:early prediction of response to neoadjuvant chemotherapy using parametric response maps for MR imaging[J].Radiology, 2014, 272(2):385-396.
[5] 曹文斌, 陈琴, 罗俊, 等.超声成像技术对乳腺癌新辅助化疗疗效评估研究进展[J].实用医院临床杂志, 2019, 16(3):250-253.
[6] 苏琳, 谭筱林, 贾亦真, 等.超声在乳腺癌新辅助化疗疗效评估中的应用价值[J].临床超声医学杂志, 2017, 19(7):440-443.
[7] BARR R G, DEVITA R, DESTOUNIS S, et al.Agreement between an automated volume breast scanner and handheld ultrasound for diagnostic breast examinations[J].J Ultrasound Med, 2017, 36(10):2087-2092.
[8] D'ANGELO A, RINALDI P, BELLI P, et al.Usefulness of automated breast volume scanner (ABVS) for monitoring tumor response to neoadjuvant treatment in breast cancer patients:preliminary results[J].Eur Rev Med Pharmacol Sci, 2019, 23(1):225-231.
[9] 黄梅, 郑斌, 王树群, 等.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.
[10] 于秋杰, 姜智允, 孟巍.声脉冲辐射力成像技术评价乳腺癌新辅助化疗疗效的价值研究[J].癌症进展, 2018, 16(3):306-308.
[11] HAMISA M, DABESS N, YOSEF R, et al.Role of breast ultrasound, mammography, magnetic resonance imaging and diffusion weighted imaging in predicting pathologic response of breast cancer after neoadjuvant chemotherapy[J].Egypt J Radiol Nucl Med, 2015, 46(1):245-257.
[12] GABRIELSEN D A, CARNEY M J, WEISSLER J M, et al.Application of ARFI-SWV in stiffness measurement of the abdominal wall musculature:a pilot feasibility study[J].Ultrasound Med Biol, 2018, 44(9):1978-1985.
[13] CHAMPION C D, REN Y, THOMAS S M, et al.DCIS with microinvasion:is it in situ or invasive disease?[J].Ann Surg Oncol, 2019, 26(10):3124-3132.
[14] OGSTON K N, MILLER I D, PAYNE S, et al.A new histological grading system to assess response of breast cancers to primary chemotherapy:prognostic significance and survival[J].Breast, 2003, 12(5):320-327.
[15] 陈万青, 郑荣寿.中国女性乳腺癌发病死亡和生存状况[J].中国肿瘤临床, 2015, 42(13):668-674.
[16] 刘嘉琳, 周杨, 吴佳玲, 等.自动乳腺全容积成像冠状面征象对乳腺良恶性病变的鉴别诊断价值[J].肿瘤影像学, 2020, 29(1):17-21.
[17] 何其佳, 赵玉珍, 阳练, 等.乳腺超声自动容积成像技术及普通超声对乳腺肿物的诊断价值比较[J].中华超声影像学杂志, 2016, 25(7):597-602.
[18] LI M, XU B, SHAO Y, et al.Magnetic resonance imaging patterns of tumor regression in breast cancer patients after neo-adjuvant chemotherapy, and an analysis of the influencing factors[J].Breast J, 2017, 23(6):656-662.
[19] SHINTIA C, ENDANG H, DIANI K.Assessment of pathological response to neoadjuvant chemotherapy in locally advanced breast cancer using the Miller-Payne system and TUNEL[J].Malays J Pathol, 2016, 38(1):25-32.
[20] 冷晓玲, 黄国福, 贾志莺, 等.超声造影在乳腺癌新辅助化疗疗效评估中的应用价值[J].中华超声影像学杂志, 2015, 24(11):984-988.
[21] GIROMETTI R, ZANOTEL M, LONDERO V, et al.Automated breast volume scanner (ABVS) in assessing breast cancer size:a comparison with conventional ultrasound and magnetic resonance imaging[J].Eur Radiol, 2018, 28(3):1000-1008.
[22] 孙建娜, 骆瑞珍, 孔令军, 等.自动乳腺全容积成像结合彩超评价乳腺癌新辅助化疗疗效的应用分析[J].中国肿瘤临床, 2014, 41(14):913-916.
[23] CRIPPA F, AGRESTI R, SANDRI M, et al.¹⁸F-FLT PET/CT as an imaging tool for early prediction of pathological response in patients with locally advanced breast cancer treated with neoadjuvant chemotherapy:a pilot study[J].Eur J Nucl Med Mol Imaging, 2015, 42(6):818-830.

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