局部晚期乳腺癌新辅助化疗后残留微钙化：乳腺钼靶摄影与 MRI 预测病理残留肿瘤准确性的比较。
Residual microcalcifications after neoadjuvant chemotherapy for locally advanced breast cancer: comparison of the accuracies of mammography and MRI in predicting pathological residual tumor.
机构信息
Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon-si, 16247, Gyeonggi-do, Republic of Korea.
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
出版信息
World J Surg Oncol. 2017 Nov 6;15(1):198. doi: 10.1186/s12957-017-1263-8.
BACKGROUND
The aims of this study were to correlate residual mammographic microcalcifications after neoadjuvant chemotherapy (NAC) with pathological results and to compare the accuracy of mammography (MG) and magnetic resonance imaging (MRI) in predicting the size of residual tumors.
METHODS
The imaging findings and pathological results for 29 patients with residual microcalcifications after NAC were reviewed. We compared the agreement of the measured extent of residual microcalcifications based on MG and residual enhancement based on MRI with the residual tumor size based on pathology.
RESULTS
At final pathology, residual microcalcifications were malignant in 55.2% of cases and benign in 44.8% of cases. In 36% of non-pCR cases, the remaining microcalcifications were benign. Compared with the measurements of residual tumor obtained from pathology, MG showed poor agreement, and MRI showed moderate agreement, for the entire group (concordance correlation coefficient [CCC] = 0.196 vs. 0.566). Regarding the receptor status, the agreement of measurements obtained by MG was superior to that obtained by MRI (CCC = 0.5629, 0.5472 vs. 0.4496, 0.4279) for ER(+) and HER2(-) tumors. In ER(-) tumors, the measurements obtained by MG showed the lowest agreement with the pathological tumor size, which had the highest agreement with those obtained by MRI (CCC = - 0.0162 vs. 0.8584).
CONCLUSIONS
Residual mammographic microcalcifications after NAC did not correlate with malignancy in 44.8% of cases. Residual microcalcifications on MG were poorly correlated with pathological tumor size, and MRI might be more reliable for predicting residual tumor size after NAC. Tumor receptor status affected the accuracy of both MG and MRI for predicting residual tumor size after NAC.
TRIAL REGISTRATION
CRIS, KCT0002281 ; registered 6 April 2015, retrospectively registered.
背景
本研究旨在将新辅助化疗（NAC）后残留的乳腺微钙化与病理结果相关联，并比较乳腺 X 线摄影（MG）和磁共振成像（MRI）在预测残留肿瘤大小方面的准确性。
方法
回顾了 29 例 NAC 后残留微钙化患者的影像学表现和病理结果。我们比较了基于 MG 测量的残留微钙化范围和基于 MRI 残留增强与基于病理的残留肿瘤大小的一致性。
结果
在最终的病理检查中，残留的微钙化在 55.2%的病例中为恶性，在 44.8%的病例中为良性。在非 pCR 病例中，36%的残留微钙化是良性的。与从病理学获得的残留肿瘤测量值相比，MG 显示出较差的一致性，而 MRI 显示出中等程度的一致性，整个组的一致性相关系数（CCC）为 0.196 对 0.566。关于受体状态，MG 获得的测量值的一致性优于 MRI（CCC = 0.5629、0.5472 对 0.4496、0.4279）对于 ER（+）和 HER2（-）肿瘤。在 ER（-）肿瘤中，MG 获得的测量值与病理肿瘤大小的一致性最低，而与 MRI 的一致性最高（CCC = -0.0162 对 0.8584）。
结论
在 44.8%的病例中，NAC 后残留的乳腺 X 线摄影微钙化与恶性无关。MG 上的残留微钙化与病理肿瘤大小相关性较差，MRI 可能更可靠地预测 NAC 后残留肿瘤的大小。肿瘤受体状态影响 MG 和 MRI 预测 NAC 后残留肿瘤大小的准确性。
试验注册
CRIS，KCT0002281；于 2015 年 4 月 6 日注册，回顾性注册。
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