| 摘要: |
| 目的 探讨超声光散射技术( ultrasound-guided diffuse optical tomography,US-DOT)预测乳腺癌新辅助化疗(neoadjuvant chemotherapy,NCT)疗效的价值。方法 乳腺癌NCT病例58例,于化疗前和末次化疗后行US-DOT检查,获取肿瘤大小和血红蛋白浓度(total hemoglobin concebtration,HBT)。根据RECIST标准将病灶分为完全缓解(complete response,CR)组、部分缓解(partial response,PR)组、稳定(stable disease,SD)组、进展(progressive disease,PD)组。分析NCT前后各组HBT值与肿瘤最大径的变化情况,Pearson相关分析肿瘤HBT变化百分比(△HBT%)与肿瘤最大径变化百分比(△Size%)的相关性,受试者工作(receiver operating characteristic,ROC)曲线预测乳腺癌NCT有效率△HBT%的最佳阈值及其诊断效能。结果 NCT后HBT值和肿瘤最大径在上述分组中均低于NCT前且组间差异有统计学意义(P<0.001)；NCT后△HBT%与△Size%各组间差异有统计学意义(P<0.05)；Pearson相关分析显示△HBT%与△Size%呈正相关(r=0.875),肿瘤最大径下降,其HBT也下降；US-DOT预测NCT有效率△HBT%为22.9%,曲线下面积(Az)为0.872,该阈值诊断效能敏感性、特异性、阳性预测值、阴性预测值、准确性分别为 82.93%、76.47%、72.34%、 36.36%、 65.52%。结论 乳腺癌NCT过程中,US-DOT参数△HBT%与△Size%呈正相关,△HBT%可术前预测乳腺癌新辅助化疗疗效。 |
| 关键词: 新辅助化疗 乳腺癌 超声光散射 |
| DOI： |
| 投稿时间：2019-11-03修订日期：2019-11-24 |
| 基金项目:甘肃省自然科学基金(1606RJZA118) |
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| Prediction of efficacy of breast cancer neoadjuvant chemotherapy using Ultrasound-Guided Diffuse Optical Tomograph |
| LIU Juan,MA Sumei,WANG Hui,Tang Fabing,Wang Honglei,Ji Kun |
| () |
| Abstract: |
| Objective To investigate the value of ultrasound-guided diffuse optical tomography(US-DOT)to predict the efficacy of neoadjuvant chemotherapy(NCT)for breast cancer.Methods Fifty-eight cases of breast cancer were treated with NCT were enrolled.Pre- and post-last chemotherapy,the size and total hemoglobin concebtration(HBT)of each lesion were measured by US-DOT.According to the RECIST standard, the lesions were divided into complete response (CR) group, partial response (PR) group, stable disease (SD) group, and progressive disease (PD) group.The analysis of changes of HBT and tumor size before and after NCT in each group；Pearson correlation analyzed the relationship between HBT changes (△HBT%) and tumor size changes (△Size%)；Receiver operating characteristic (ROC) curve predicted the optimal threshold of △HBT% and its diagnostic efficacy for breast cancer neoadjuvant chemotherapy. Results In the above groups, the HBT and size of the lesion after NCT were lower than that before NCT, and the difference between the groups were statistically significant (P<0.001).After NCT,the difference of △HBT% and △Size% were statistically significant in each group(P<0.05).Pearson correlation analysis showed that △HBT% was positively correlated with △Size% (r=0.875).While △HBT%=22.9% as the threshold for prediction of efficiency for NCT,the area under the curve of ROC (Az) was 0.872, and the sensitivity was 82.93%, , specificity was 76.47%, positive predictive value was 72.34%, negative predictive value was 36.36%,and accuracy was 65.52%, respectively.Conclusions During neoadjuvant chemotherapy for breast cancer, US-DOT parameter △HBT% was positively correlated with △Size%.△HBT% can predict the efficacy of neoadjuvant chemotherapy for breast cancer before operation. |
| Key words: Neoadjuvant chemotherapy,Breast cancer,Diffuse optical tomography |
