[1]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.[doi:DOI:10.3969/j.issn.1005-202X.2019.07.010]
　LUO Yixian,MAJie,LIU Yongguang,et al.Dynamic contrast-enhanced MRI for assessing and predicting the response of breast cancer toneoadjuvant chemotherapy[J].Chinese Journal of Medical Physics,2019,36(7):794-799.[doi:DOI:10.3969/j.issn.1005-202X.2019.07.010]
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动态增强MRI对乳腺癌新辅助化疗的疗效评价及预测()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
36卷
期数:
2019年第7期
页码:
794-799
栏目:
医学影像物理
出版日期:
2019-07-25

文章信息/Info

Title:
Dynamic contrast-enhanced MRI for assessing and predicting the response of breast cancer to neoadjuvant chemotherapy
文章编号:
1005-202X（2019）07-0794-06
作者:
罗益贤; 马捷; 刘永光; 弋春燕; 许梅; 黄社磊
深圳市人民医院（暨南大学第二临床学院）放射科，广东深圳518109
Author(s):
LUO Yixian;  MAJie;  LIU Yongguang;  YI Chunyan;  XU Mei;  HUANG Shelei
Department of Radiology, Shenzhen People’s Hospital (the Second Clinical Medical College of Ji’nan University), Shenzhen 518109, China
关键词:
乳腺癌; 新辅助化疗; 动态增强MRI; 疗效
Keywords:
Keywords: breast cancer;  neoadjuvant chemotherapy;  dynamic contrast-enhanced magnetic resonance imaging;  therapeutic effect
分类号:
R445.2；R737.9
DOI:
DOI:10.3969/j.issn.1005-202X.2019.07.010
文献标志码:
A
摘要:
【摘要】目的：探讨动态增强MRI评价和预测乳腺癌新辅助化疗（NAC）疗效的价值。方法：回顾性分析45例经手术病理 证实为浸润性乳腺癌并行术前NAC的患者资料。依据化疗前后组织病理学改变进行的疗效评价，将病人分为病理完全 缓解组和病理非完全缓解组。对比分析化疗前后两组动态增强MRI检查参数数值变化的差异，以病理反应性标准分组 为金标准，对其中有统计学意义的参数进行ROC曲线分析，并计算ROC曲线下面积（AUC），评价各参数对NAC疗效的 评价效能，最后根据分析结果建立乳腺癌NAC疗效预测模型Logist P。结果：病理完全缓解组有16例患者，而病理非完 全缓解组有29例患者。两组间肿瘤最大经线变化率、肿瘤体积变化率、早期强化程度变化、时间信号强度曲线最大线性 斜率变化率、时间信号强度曲线类型的变化差异均有统计学意义（P<0.05）。最大经线变化率、肿瘤体积变化率、早期强化 程度变化、时间信号强度曲线最大线性斜率变化率、时间信号强度曲线类型的变化的AUC分别为0.711、0.759、0.711、 0.795、0.692，灵敏度/特异度分别为0.38/0.97、0.81/0.66、0.56/0.83、0.75/0.76、0.69/0.62，联合肿瘤体积变化率和最大线性 斜率变化率的Logist P模型的AUC为0.793（95%CI 0.644~0.942）。结论：早期动态增强MRI参数能用于评价和预测乳腺 癌NAC疗效。
Abstract:
Abstract: Objective To explore the value of dynamic contrast-enhanced MRI for assessing and predicting the therapeutic effects of neoadjuvant chemotherapy (NAC) for breast cancer. Methods A retrospective analysis was performed on the clinical data of 45 patients with invasive breast cancer confirmed by surgery and pathology who received NAC before surgery. According to therapeutic effect of NAC for breast cancer which was evaluated by the histopathological changes before and after chemotherapy, the patients were divided into pathologic complete response (pCR) group and non-pathologic complete response (NpCR) group. The dynamic contrast-enhanced MRI parameters in 2 groups were analyzed before and after chemotherapy. The pathological result was used as gold standard. Receiver operating characteristic curve (ROC) analysis was performed on the parameters with statistical significance, and the corresponding area under curve (AUC) was calculated to evaluate the effectiveness of the parameters in assessing the therapeutic effect of NAC. Based on the analyzed results, Logist Pmodel was established for predicting the therapeutic effect of NAC for breast cancer. Results Among the 45 cases, there were 16 in pCR group and 29 in NpCR group. Significant difference was found in tumor maximum meridian change rate (ΔD%), tumor volume change rate (ΔV%), change of early intensive degree (ΔS%), maximum linear slope change rate of time-intensity curve (ΔSmax%), changes of time-intensity curve type (ΔTIC) between pCR group and NpCR group (P<0.05). The AUC of ΔD%, ΔV%, ΔS%, ΔSmax% and ΔTIC were 0.711, 0.759, 0.711, 0.795 and 0.692, respectively, and the sensitivity/specificity were 0.38/0.97, 0.81/0.66, 0.56/0.83, 0.75/0.76 and 0.69/0.62, respectively. The AUC of Logit P model combining tumor volume change rate and maximum linear slope change rate of time-intensity curve for pathological prediction was 0.793 (95%CI 0.644-0.942). Conclusion The dynamic contrast-enhanced MRI parameters in the early stage can be used for assessing and predicting the response of breast cancer to NAC.

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备注/Memo

备注/Memo:
【收稿日期】2019-01-20 【基金项目】广东省医学科研研究基金（A2018493）；深圳市科技研发基金（JCYJ20180305164740612） 【作者简介】罗益贤，主治医师，主要从事放射影像诊断，E-mail: 65503424@qq.com 【通信作者】马捷，主任医师，主要从事乳腺疾病影像诊断，E-mail: 1798045437@qq.com
更新日期/Last Update: 2019-07-25