[1]杨季春,卿伯华,杨民正.动态增强MRI预测乳腺癌新辅助化疗后病理完全缓解的准确性[J].医学信息,2024,37(22):102-105.[doi:10.3969/j.issn.1006-1959.2024.22.025]
　YANG Jichun,QING Bohua,YANG Minzheng.Accuracy of Dynamic Contrast-enhanced MRI in Predicting Pathological Complete Response After Neoadjuvant Chemotherapy for Breast Cancer[J].Journal of Medical Information,2024,37(22):102-105.[doi:10.3969/j.issn.1006-1959.2024.22.025]
点击复制

动态增强MRI预测乳腺癌新辅助化疗后病理完全缓解的准确性()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年22期
页码:
102-105
栏目:
论著
出版日期:
2024-11-15

文章信息/Info

Title:
Accuracy of Dynamic Contrast-enhanced MRI in Predicting Pathological Complete Response After Neoadjuvant Chemotherapy for Breast Cancer
文章编号:
1006-1959（2024）22-0102-04
作者:
杨季春; 卿伯华; 杨民正
永州市中心医院冷水滩院区放射科，湖南 永州 425000
Author(s):
YANG Jichun; QING Bohua; YANG Minzheng
Department of Radiology,the Central Hospital of Yongzhou City Lengshuitan Hospital,Yongzhou 425000,Hunan,China
关键词:
乳腺癌; 新辅助化疗; 病理完全缓解; 肿瘤周围水肿
Keywords:
Breast cancer; Neoadjuvant chemotherapy; Pathological complete remission; Peritumor edema
分类号:
R445
DOI:
10.3969/j.issn.1006-1959.2024.22.025
摘要:
目的 探讨动态增强MRI预测乳腺癌新辅助化疗后病理完全缓解的准确性。方法 选取2018年12月-2021年12月在我院接受治疗的316例乳腺癌患者为研究对象，比较新辅助化疗以及手术治疗之后的放射完全缓解（rCR）与病理完全缓解（pCR）判定结果，对比真阳性和假阳性患者、真阴性和假阴性患者新辅助化疗后的MRI参数。结果 以术后病理学检查pCR的结果作为金标准，MRI检查的rCR预测的灵敏度为81.82%，特异度为32.43%，准确度为70.25%，阳性预测值为79.84%，阴性预测值为35.29%，与pCR的Kappa值为0.15。新辅助化疗后，真阳性和假阳性患者的肿瘤直径、背景实质强化、肿瘤周围水肿比例比较，差异有统计学意义（P＜0.05）；真阴性和假阴性患者的乳腺组织密度、肿瘤边缘强化比较，差异有统计学意义（P＜0.05）。结论 动态增强MRI检查能够作为预测乳腺癌新辅助化疗后pCR预测的重要手段，对于预测准确性有影响的指标，需要在工作中给予足够的关注，进一步提升预测的准确性。
Abstract:
Objective To investigate the accuracy of dynamic contrast-enhanced MRI in predicting the pathological complete remission of breast cancer after neoadjuvant chemotherapy.Methods A total of 316 patients with breast cancer who were treated in our hospital from December 2018 to December 2021 were selected as the research objects. The results of radiation complete remission (rCR) and pathological complete remission (pCR) after neoadjuvant chemotherapy and surgical treatment were compared. The MRI parameters of true positive and false positive patients, true negative and false negative patients after neoadjuvant chemotherapy were compared.Results With the results of postoperative pathological examination of pCR as the gold standard, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of rCR in MRI were 81.82%, 32.43%, 70.25%, 79.84% and 35.29%, respectively, the Kappa value with pCR was 0.15. After neoadjuvant chemotherapy, there were significant differences in tumor diameter, background parenchymal enhancement and peritumoral edema between true positive and false positive patients(P<0.05). There were significant differences in breast tissue density and tumor edge enhancement between true negative and false negative patients(P<0.05).Conclusion Dynamic contrast-enhanced MRI can be used as an important means to predict pCR after neoadjuvant chemotherapy for breast cancer. For indicators that affect the accuracy of prediction, sufficient attention needs to be paid in the work to further improve the accuracy of prediction.

参考文献/References:

[1]莫丹,陈喜裕,何婕,等.血清microRNA-186-5p、microRNA-328-5p表达和乳腺癌患者临床病理特征与新辅助化疗效果的关系[J].中国现代医学杂志,2023,33(5):9-15.[2]Von Minckwitz G,Untch M,Blohmer JU,et al.Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes[J].J Clin Oncol,2012,30(15):1796-1804.[3]牟园,熊昱,秦烨.雌激素受体阳性乳腺癌内分泌治疗耐药机制及靶向治疗策略[J].生命科学,2022,34(12):1559-1568.[4]李俊杰,邵志敏.2018年美国《国家综合癌症网络乳腺癌临床实践指南》解读[J].中华乳腺病杂志(电子版),2018,12(3):129-134.[5]Schaefgen B,Mati M,Sinn HP,et al.Can routine imaging after neoadjuvant chemotherapy in breast cancer predict pathologic complete response?[J].Ann Surg Oncol,2016,23(3):789-795.[6]朱庆莉,姜玉新.乳腺影像报告与数据系统指南(第5版)超声内容更新介绍[J].中华医学超声杂志(电子版),2016,13(1):5-7.[7]Santamaría G,Bargalló X,Fernández PL,et al.Neoadjuvant systemic therapy in breast cancer: association of contrast-enhanced MR imaging findings, diffusion-weighted imaging findings, and tumor subtype with tumor response[J].Radiology,2017,283(3):663-672.[8]Cortazar P,Zhang LJ,Untch M,et al.Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis[J].Lancet,2014,384(9938):64-172.[9]Yu N,Leung VWY,Meterissian S.MRI performance in detecting pCR after neoadjuvant chemotherapy by molecular subtype of breast cancer[J].World J Surg,2019,43(9):2254-2261.[10]崔嵘嵘,许诚,卢晓玲,等.乳腺癌患者新辅助化疗后核磁共振功能成像与超声造影检查对于疗效评价的准确性探讨[J].中国医师进修杂志,2014,37(8):24-27.[11]李俏颖,周定中.超声与MRI诊断乳腺癌及不同病理分型影像特点分析[J].中国医学物理学杂志,2019,36(2):205-209. [12]De Los Santos JF,Cantor A,Amos KD,et al.Magnetic resonance imaging as a predictor of pathologic response in patients treated with neoadjuvant systemic treatment for operable breast cancer.Translational Breast Cancer Research Consortium trial 017[J].Cancer,2013,119(10):1776-1783.[13]王硕,李骥,彭飞. 磁共振联合乳腺癌分子分型预测新辅助化疗乳腺癌患者的预后[J].中国煤炭工业医学杂志,2023,26(1):32-37.[14]盛盼,杨林,汪婷.DCE-MRI定量分析评估消癌平联合新辅助化疗治疗乳腺癌临床疗效及近期预后[J].中国CT和MRI杂志,2021,19(9):86-88,127.[15]罗益贤,马捷,刘永光,等.动态增强MRI对乳腺癌新辅助化疗的疗效评价及预测[J].中国医学物理学杂志,2019,36(7):794-799.[16]孙晨,李鲁,雷启超,等.DCE-MRI在乳腺癌新辅助化疗疗效评价中的价值[J].浙江临床医学,2023,25(9):1366-1368.[17]刘红宇,吴海鸰,徐祖良,等.应用MRI预测三阴性乳腺癌的危险因素分析[J].中国临床医学影像杂志,2013,24(4):274-277.[18]唐竹晓,徐丽娜,孙召龙,等.应用DCE-MRI联合DWI序列评估乳腺癌术前新辅助化疗疗效的可行性研究[J].中国CT和MRI杂志,2021,19(7):100-102.[19]徐卫云,赵洁玉,张靖,等.西部二级城市女性乳腺癌发病风险相关因素分析及风险预测模型的建立[J].中国普外基础与临床杂志,2013,20(10):1106-1112.[20]Schmitz AM,Loo CE,Wesseling J,et al.Association between rim enhancement of breast cancer on dynamic contrast-enhanced MRI and patient outcome: impact of subtype[J].Breast Cancer Res Treat,2014,148(3):541-551.

相似文献/References:

[1]屈欣然.DCE-MRI对局部进展期乳腺癌新辅助化疗的临床指导价值研究[J].医学信息,2018,31(04):34.[doi:10.3969/j.issn.1006-1959.2018.04.012]
　QU Xin-ran.Clinical Value of DCE-MRI in Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer[J].Journal of Medical Information,2018,31(22):34.[doi:10.3969/j.issn.1006-1959.2018.04.012]
[2]董 云.SPECT/CT 双时相99mTc- MIBI断层显像 在乳腺癌诊断中的应用[J].医学信息,2018,31(05):147.[doi:10.3969/j.issn.1006-1959.2018.05.053]
　DONG Yun.Application of SPECT/CT Dual-phase 99mTc-MIBI Tomography in the Diagnosis of Breast Cancer[J].Journal of Medical Information,2018,31(22):147.[doi:10.3969/j.issn.1006-1959.2018.05.053]
[3]李建辉,祝旭龙.乳腺癌的治疗管理——把好生活质量关[J].医学信息,2018,31(13):1.[doi:10.3969/j.issn.1006-1959.2018.13.001]
[4]杨玉峰,李 强,曲国红,等.乳腺癌术前巴德枪穿刺检测ER、PR的临床研究[J].医学信息,2018,31(13):163.[doi:10.3969/j.issn.1006-1959.2018.13.050]
　YANG Yu-feng,LI Qiang,QU Guo-hong,et al.Clinical Study on Preoperative ER and PR Detection of Bard Gun Puncture in Breast Cancer[J].Journal of Medical Information,2018,31(22):163.[doi:10.3969/j.issn.1006-1959.2018.13.050]
[5]刘 曼,厉玛倩倩,徐润润,等.延续性护理对乳腺癌术后化疗患者生活质量与 健康知识水平的影响[J].医学信息,2018,31(16):178.[doi:10.3969/j.issn.1006-1959.2018.16.057]
　LIU Man,LIMA Qian-qian,XU Run-run,et al.Effect of Continuous Nursing on Quality of Life and Health Knowledge of Postoperative Chemotherapy Patients with Breast Cancer[J].Journal of Medical Information,2018,31(22):178.[doi:10.3969/j.issn.1006-1959.2018.16.057]
[6]张艳萍,曹 玉,孙国平.服用阿司匹林对乳腺癌患者生存获益的Meta分析[J].医学信息,2018,31(20):72.[doi:10.3969/j.issn.1006-1959.2018.20.021]
　ZHANG Yan-ping,CAO Yu,SUN Guo-ping.Meta Analysis of the Survival Benefit of Patients with Breast Cancer Treated with Aspirin[J].Journal of Medical Information,2018,31(22):72.[doi:10.3969/j.issn.1006-1959.2018.20.021]
[7]钟 磊,谢海燕,林 霖.电化学发光免疫分析技术检测肿瘤标志物在乳腺癌诊断中的应用[J].医学信息,2018,31(20):155.[doi:10.3969/j.issn.1006-1959.2018.20.048]
　ZHONG Lei,XIE Hai-yan,LIN Lin.Application of Electrochemiluminescence Immunoassay for Detection of Tumor Markers in Diagnosis of Breast Cancer[J].Journal of Medical Information,2018,31(22):155.[doi:10.3969/j.issn.1006-1959.2018.20.048]
[8]苏 志,吴 蔚,吴智钢,等.含洛铂方案新辅助化疗结合保肢手术治疗骨肉瘤的临床疗效观察[J].医学信息,2018,31(21):83.[doi:10.3969/j.issn.1006-1959.2018.21.022]
　SU Zhi,WU Wei,WU Zhi-gang,et al.Clinical Efficacy of Neoadjuvant Chemotherapy with Lobaplatin Combined with Limb Salvage Surgery for OsteosarcomaC[J].Journal of Medical Information,2018,31(22):83.[doi:10.3969/j.issn.1006-1959.2018.21.022]
[9]胡平华,黄 勤,李志华.含卡培他滨方案一线或后线治疗晚期乳腺癌的效果对比[J].医学信息,2018,31(22):142.[doi:10.3969/j.issn.1006-1959.2018.22.041]
　HU Ping-hua,HUANG Qin,LI Zhi-hua.Comparison of the Efficacy of Capecitabine Regimen in the Treatment of Advanced Breast Cancer with First-line or Posterior Line Therapy[J].Journal of Medical Information,2018,31(22):142.[doi:10.3969/j.issn.1006-1959.2018.22.041]
[10]阙海涛,曹 斌,秦志刚.EGFL7在乳腺癌中的研究进展[J].医学信息,2018,31(23):32.[doi:10.3969/j.issn.1006-1959.2018.23.010]
　QUE Hai-tao,CAO Bin,QIN Zhi-gang.Research Progress of EGFL7 in Breast Cancer[J].Journal of Medical Information,2018,31(22):32.[doi:10.3969/j.issn.1006-1959.2018.23.010]
[11]付大鹏.多西他赛联合表柔比星新辅助化疗治疗乳腺癌的效果[J].医学信息,2020,33(05):149.[doi:10.3969/j.issn.1006-1959.2020.04.048]
　FU Da-peng.Evaluation of Docetaxel Combined with Epirubicin Neoadjuvant Chemotherapy for Breast Cancer[J].Journal of Medical Information,2020,33(22):149.[doi:10.3969/j.issn.1006-1959.2020.04.048]
[12]陈甜甜,潘跃银,沈夏波.新辅助内分泌治疗与新辅助化疗用于乳腺癌中的短期疗效Meta分析[J].医学信息,2020,33(14):67.[doi:10.3969/j.issn.1006-1959.2020.14.020]
　CHEN Tian-tian,PAN Yue-yin,SHEN Xia-bo.Meta-analysis of Short-term Efficacy of Neoadjuvant Endocrine Therapy and Neoadjuvant Chemotherapy in Breast Cancer[J].Journal of Medical Information,2020,33(22):67.[doi:10.3969/j.issn.1006-1959.2020.14.020]
[13]张 虎,张 涛,徐 芳,等.MRI在乳腺癌诊治中的研究进展[J].医学信息,2022,35(10):62.[doi:10.3969/j.issn.1006-1959.2022.10.015]
　ZHANG Hu,ZHANG Tao,XU Fang,et al.Research Progress of MRI in Diagnosis and Treatment of Breast Cancer[J].Journal of Medical Information,2022,35(22):62.[doi:10.3969/j.issn.1006-1959.2022.10.015]
[14]关利平,李建文.凝血相关指标与乳腺癌新辅助化疗疗效预测的相关性研究[J].医学信息,2022,35(16):159.[doi:10.3969/j.issn.1006-1959.2022.16.041]
　GUAN Li-ping,LI Jian-wen.Study on Correlation Between Coagulation- related Indexes and Efficacy Prediction of Neoadjuvant Chemotherapy for Breast Cancer[J].Journal of Medical Information,2022,35(22):159.[doi:10.3969/j.issn.1006-1959.2022.16.041]
[15]周靖宇,单慧明,成官迅.基于支持向量机的全乳纹理分析预测乳腺癌新辅助化疗疗效的价值[J].医学信息,2022,35(19):60.[doi:10.3969/j.issn.1006-1959.2022.19.016]
　ZHOU Jing-yu,SHAN Hui-ming,CHENG Guan-xun.Prediction of Neoadjuvant Chemotherapy Outcomes of Breast Cancer Based on Whole Breast Texture with Support Vector Machine[J].Journal of Medical Information,2022,35(22):60.[doi:10.3969/j.issn.1006-1959.2022.19.016]
[16]樊 婷,刘新兰２.乳腺癌组织中TOP2A蛋白表达临界值及其与蒽环紫杉类新辅助化疗疗效相关性研究[J].医学信息,2025,38(01):79.[doi:10.3969/j.issn.1006-1959.2025.01.014]
　FAN Ting,LIU Xinlan.Critical Value of TOP2A Protein Expression in Breast Cancer Tissues and its Correlation with the Efficacy of Anthracycline Neoadjuvant Chemotherapy[J].Journal of Medical Information,2025,38(22):79.[doi:10.3969/j.issn.1006-1959.2025.01.014]

更新日期/Last Update: 1900-01-01