磁共振成像（MRI）在评估局部晚期乳腺癌新辅助化疗肿瘤反应中的有效性

The validity of MRI in evaluation of tumor response to neoadjuvant chemotherapy in locally advanced breast cancer.

作者信息

Abedi Mahboobeh, Farrokh Donya, Shandiz Homaei Fatemeh, Joulaee Azadeh, Anbiaee Robab, Zandi Behrooz, Gity Masoumeh, Sayah Hamid Reza, Abedi Mohammad Sadegh

机构信息

Dept. of Radiology, Imam Reza Hospital, Mashad University of Medical Sciences, Mashad, Iran.

Solid Tumor Treatment Research Center, Mashad University of Medical Sciences, Mashad, Iran.

出版信息

Iran J Cancer Prev. 2013 Winter;6(1):28-35.

BACKGROUND

Physical Examination (PE) and breast MRI are two of the currentmethods which have usually used in diagnosis of primary breast cancer. Their accuracy in detection of: either complete response or presence of residual tumor, however, has not yet been established in patients who have been received Neoadjuvant Chemotherapy (NAC).The purpose of this study was to evaluate the diagnostic accuracy of breast MRI in assessment of residual neoplastic tissue after NAC in patients with Locally Advanced Breast Cancer (LABC).

METHODS

Twenty patients with LABC have undergone contrast-enhanced MRI before and after the NAC. Considering histology as the gold standard, the tumor sizes in MRI and PE have compared with the histology results. We have calculated for all below: the accuracy, sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) for each of MRI and physical examination, as well as Pearson's correlation coefficients between the results of MRI and PE, and their histology results.

RESULTS

We have found an accuracy of 85% for MRI with a sensitivity of 100%, a specificity of 50%, a PPV of 83.3%, and an NPV of 100%. In addition, theaccuracy for PE was 70% with a sensitivity of 71.4%, a specificity of 66.6%, a PPV of 83.3%, and an NPV of 50%. In this study, the calculated Pearson's correlation coefficient for MRI and histology was 0.817 (p<0.0001) versus 0.26 (p=0.26) for correlation between PE and histology.

CONCLUSION

MRI has higher sensitivity but less specificity than PE for detection of residual tumor after NAC in locally advanced breast carcinoma. Also, the tumor size that has measured by MRI had highly correlation with the histology.

背景

体格检查（PE）和乳腺MRI是目前常用于原发性乳腺癌诊断的两种方法。然而，对于接受新辅助化疗（NAC）的患者，它们在检测完全缓解或残留肿瘤方面的准确性尚未得到证实。本研究的目的是评估乳腺MRI在评估局部晚期乳腺癌（LABC）患者接受NAC后残留肿瘤组织的诊断准确性。

方法

20例LABC患者在NAC前后接受了对比增强MRI检查。以组织学为金标准，将MRI和PE中的肿瘤大小与组织学结果进行比较。我们计算了以下各项：MRI和体格检查各自的准确性、敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV），以及MRI和PE结果与它们的组织学结果之间的Pearson相关系数。

结果

我们发现MRI的准确性为85%，敏感性为100%，特异性为50%，PPV为83.3%，NPV为100%。此外，PE的准确性为70%，敏感性为71.4%，特异性为66.6%，PPV为83.3%，NPV为50%。在本研究中计算得出，MRI与组织学之间的Pearson相关系数为0.817（p<0.0001），而PE与组织学之间的相关系数为0.26（p=0.26）。