| 摘要: |
| 摘要：目的：应用超声组织弥散定量分析技术检测乳腺癌TAC联合化疗患者的肝脏组织弹性特征，为早期评估其肝损伤提供一种有效的超声定量检测方法。
资料与方法：使用前瞻性随机对照研究，选取38名门诊健康体检者为健康对照组，35名经病理证实为乳腺癌且需行6周期TAC联合化疗的住院患者为化疗组。行肝脏常规超声检查及超声组织弥散定量分析，测量肝纤维化指数（LFI）、蓝色区域面积百分比（%AREA）、应变均值（MEAN）；并进行肝功能生化检测，包括：谷氨酸转氨基酶（ALT）、天冬氨酸转氨基酶（AST）。分别对上述检测内容进行化疗前组间比较以及化疗组不同化疗周期间的比较，并将LFI、%AREA及MEAN与肝功生化指标做相关性分析。
结果：1.化疗前组间比较各项超声弹性参数及肝功能生化指标均无统计学意义（P>0.05）。化疗组患者在化疗第2、4、6周期结束后分别与化疗前比较：化疗第2周期后，%AREA及LFI增高（P<0.05）；ALT、AST呈上升趋势（P<0.05），但AST仍在正常范围，ALT处于正常上限值。化疗第4及第6周期后，MEAN减低（P<0.05），%AREA及LFI增高（P<0.05）；ALT及AST升高（P<0.05）。将化疗组患者化疗第4与第2周期后比较，第6与第2周期后比较，第6与第4周期后比较，均得到MEAN减低（P<0.05），%AREA及LFI增高（P<0.05）；ALT及AST升高（P<0.05）的结果。2.扣除化疗周期的影响，LFI与ALT（r=0.341, P=0.000）、%AREA与ALT（r=0.261，P=0.002）均呈正相关，MEAN与ALT（r=-0.215，P=0.011）呈负相关。
结论：超声组织弥散定量分析技术能够定量检测乳腺癌化疗患者肝组织的弹性特征；LFI%，AREA及MEAN有望成为定量检测TAC化疗乳腺癌病人早期肝损伤的有效指标。 |
| 关键词: 超声弹性成像 组织弥散定量分析 乳腺癌 TAC联合化疗 肝损伤 |
| DOI： |
| 投稿时间：2018-03-13修订日期：2018-03-20 |
| 基金项目: |
|
| Evaluation of liver injury in breast cancer patients treated with TAC combined chemotherapy by ultrasonic elastography of tissue dispersion quantitative analysis |
| zhangxiaotong,yinli,guoliping |
| () |
| Abstract: |
| Abstract ：Purpose: To assess the liver tissue elasticity of breast cancer patients treated with TAC combined chemotherapy by ultrasonic tissue dispersion quantitative analysis, and to provide an effective quantitative ultrasonic method for early assessment of liver injury. Materials and Methods: This study is a prospective controlled study. 38 healthy people were selected as the control group, and 35 patients with breast cancer confirmed by pathology who needed 6 cycles of TAC combined chemotherapy were selected as the chemotherapy group. Routine liver ultrasonography and tissue dispersion quantitative measurement were performed to get the following data: liver fibrosis index (LFI), the percentage of blue area (%AREA), the mean strain (MEAN). Biochemical test were also performed to get liver function data including glutamate transaminase (ALT) and aspartate aminotransferase (AST). The data were compared between two groups before chemotherapy, and among the different chemotherapy cycles. Correlation analysis was performed between biochemical index and elastic index including LFI, %AREA and MEAN. Results: 1. There was no significant difference between the two groups before chemotherapy. In the chemotherapy group, compared with the data before chemotherapy, LFI and %AREA increased (P<0.05), and ALT, AST has a tendency to incresase, but AST was still within normal limit and ALT almost reached upper normal limit after the 2nd cycle. After the 4th cycle and the 6th cycle, MEAN decreased while %AREA and LFI increased（P<0.05）. Also, ALT and AST increased (P<0.05). In the chemotherapy group, after the 4th cycle, MEAN decreased while %AREA and LFI increased（P<0.05）and ALT, AST increased（P<0.05） compared to the data after the 2nd cycle. After the 6th cycle, MEAN decreased while %AREA and LFI increased（P<0.05）and ALT, AST increased（P<0.05） compared to the data after the 2nd cycle and after the 4th cycle. 2. Removing the effect of chemotherapy cycles，LFI was positively correlated with ALT（r=0.341, P=0.000）, %AREA was positively correlated with ALT（r=0.261，P=0.002）, and MEAN was negatively correlated with ALT（r=-0.215, P=0.011）. Conclusion: The technology of ultrasonic elastography tissue dispersion quantitative analysis can be used to assess the elastic characteristics of liver tissue quantitively in breast cancer patients undergoing chemotherapy. LFI, %AREA and MEAN are expected to be effective indexes to evaluate early liver injury in patients of breast cancer with TAC combined chemotherapy quantitively. |
| Key words: Ultrasound elastography Tissue dispersion quantitative analysis Breast cancer TAC combination chemotherapy Liver damage |
