使用多参数 MRI 预测局部晚期乳腺癌患者新辅助化疗的病理反应。

Predicting pathologic response to neoadjuvant chemotherapy in patients with locally advanced breast cancer using multiparametric MRI.

机构信息

Department of Oncology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Lujiang Road 17, Hefei, 230001, Anhui, China.

Department of Medical Oncology, Anhui Provincial Hospital Affiliated To Anhui Medical University, Hefei, 230032, Anhui, China.

出版信息

BMC Med Imaging. 2021 Oct 23;21(1):155. doi: 10.1186/s12880-021-00688-z.

BACKGROUND

This study aims to observe and analyze the effect of diffusion weighted magnetic resonance imaging (MRI) on the patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy.

METHODS

Fifty patients (mean age, 48.7 years) with stage II-III breast cancer who underwent neoadjuvant chemotherapy and preoperative MRI between 2016 and 2020 were retrospectively evaluated. The associations between preoperative breast MRI findings/clinicopathological features and outcomes of neoadjuvant chemotherapy were assessed.

RESULTS

Clinical stage at baseline (OR: 0.104, 95% confidence interval (CI) 0.021-0.516, P = 0.006) and standard apparent diffusion coefficient (ADC) change (OR: 9.865, 95% CI 1.024-95.021, P = 0.048) were significant predictive factors of the effects of neoadjuvant chemotherapy. The percentage increase of standard ADC value in pathologic complete response (pCR) group was larger than that in non-pCR group at first time point (P < 0.05). A correlation was observed between the change in standard ADC values and tumor diameter at first follow-up (r: 0.438, P < 0.05).

CONCLUSIONS

Our findings support that change in standard ADC values and clinical stage at baseline can predict the effects of neoadjuvant chemotherapy for patients with breast cancer in early stage.

背景

本研究旨在观察和分析扩散加权磁共振成像（MRI）对接受新辅助化疗的局部晚期乳腺癌患者的影响。

方法

回顾性分析 2016 年至 2020 年间接受新辅助化疗和术前 MRI 的 50 例 II-III 期乳腺癌患者（平均年龄 48.7 岁）。评估术前乳腺 MRI 表现/临床病理特征与新辅助化疗结果之间的关系。

结果

基线时临床分期（OR：0.104，95%置信区间（CI）0.021-0.516，P=0.006）和标准表观扩散系数（ADC）变化（OR：9.865，95%CI 1.024-95.021，P=0.048）是新辅助化疗效果的显著预测因素。在首次时间点，病理完全缓解（pCR）组的标准 ADC 值增加百分比大于非 pCR 组（P<0.05）。标准 ADC 值的变化与首次随访时肿瘤直径之间存在相关性（r：0.438，P<0.05）。