Department of Ultrasound, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang, China.
Department of Hematology and Oncology, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011 Xinjiang, China.
Biomed Res Int. 2020 Nov 17;2020:3869538. doi: 10.1155/2020/3869538. eCollection 2020.
Nonluminal breast cancer has high early metastasis and treatment resistance, and neoadjuvant chemotherapy (NAC) is needed. The presence of cancer stem cells (CSC) and epithelial-mesenchymal transition (EMT) leads to poor prognosis. This study investigated the changes in CSC markers and EMT markers after NAC in nonluminal breast cancer and their correlation with contrast-enhanced ultrasound (CEUS) features and chemotherapy efficacy. Before NAC, the range of nonluminal breast cancer on CEUS was larger than that of two-dimensional ultrasound, but after NAC, it was significantly smaller than that of two-dimensional ultrasound and closer to the postoperative pathological size. After NAC, the enlarged lesions and perfusion defects were significantly less than those before NAC. The time-intensity curve showed the characteristics of slow-in, low enhancement, and low perfusion. Nonluminal breast cancer downregulated the expression of CSC markers and EMT markers after NAC, but the epithelial phenotype of nonluminal breast cancer with good response to chemotherapy was upregulated. In nonluminal breast cancer with poor response to chemotherapy, markers of CSC and EMT were highly expressed before chemotherapy. In conclusion, CEUS is better than conventional ultrasound in estimating NAC efficacy in this mode. CEUS can also predict the prognosis of nonluminal breast cancer before NAC with the characteristics of enhanced enlargement and perfusion defects. The contrast-enhanced time-intensity curve of lesions with relatively poor blood supply may have more CSC and EMT characteristics.
非腔面型乳腺癌早期转移和治疗耐药性高，需要新辅助化疗（NAC）。癌症干细胞（CSC）和上皮间质转化（EMT）的存在导致预后不良。本研究探讨了非腔面型乳腺癌 NAC 后 CSC 标志物和 EMT 标志物的变化及其与对比增强超声（CEUS）特征和化疗疗效的相关性。在 NAC 之前，CEUS 上非腔面型乳腺癌的范围大于二维超声，但 NAC 后，明显小于二维超声，更接近术后病理大小。NAC 后，增大的病变和灌注缺损明显少于 NAC 前。时间强度曲线显示出缓慢进入、低增强和低灌注的特征。NAC 后，非腔面型乳腺癌下调了 CSC 标志物和 EMT 标志物的表达，但对化疗反应良好的非腔面型乳腺癌的上皮表型上调。在对化疗反应不佳的非腔面型乳腺癌中，化疗前 CSC 和 EMT 标志物高表达。总之，CEUS 在这种模式下优于常规超声来评估 NAC 的疗效。CEUS 还可以通过增强的扩大和灌注缺损的特征来预测 NAC 前非腔面型乳腺癌的预后。相对血供较差的病变的增强时间强度曲线可能具有更多的 CSC 和 EMT 特征。
