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[乳腺癌初次治疗后的早期复发:临床病理及影像学预测因素分析]

[Early Recurrence of Breast Cancer after the Primary Treatment: Analysis of Clinicopathological and Radiological Predictive Factors].

作者信息

Yun Sun Geun, An Yeong Yi, Kim Sung Hun, Kang Bong Joo

出版信息

Taehan Yongsang Uihakhoe Chi. 2020 Mar;81(2):395-408. doi: 10.3348/jksr.2020.81.2.395. Epub 2020 Feb 18.

Abstract

PURPOSE

To evaluate the value of clinicopathologic factors and imaging features of primary breast cancer in predicting early recurrence after the primary treatment.

MATERIALS AND METHODS

We enrolled 480 patients who had been followed-up after breast-conserving surgery and adjuvant therapy from January 2010 to December 2014 at our hospital. Early recurrence was defined as recurrence within 3 years after completion of primary treatment, and univariate and multivariate logistic regression analyses were performed to determine the clinicopathologic and imaging predictive factors of early recurrence.

RESULTS

In the univariate analysis, among the clinicopathologic factors, advanced stage ( = 0.021), high histologic grade ( < 0.001), estrogen receptor negative ( = 0.002), high Ki-67 proliferation index ( = 0.017), and triple-negative breast cancer ( = 0.019), and among the imaging features, multifocality ( < 0.001), vessels in the rim on Doppler ultrasonography (US) ( = 0.012), and rim enhancement ( < 0.001) on magnetic resonance imaging of the breast were significantly associated with early recurrence. In the multivariate analysis, advanced stage [odds ratio (OR) = 3.47; 95% confidence interval (CI) 1.12-10.73; = 0.031] and vessels in the rim on Doppler US (OR = 3.32; 95% CI 1.38-8.02; = 0.008) were the independent predictive factors of early recurrence.

CONCLUSION

Vascular findings in the rim of the primary breast cancer on Doppler US before treatment is a radiologic independent predictive factor of early recurrence after the primary treatment.

摘要

目的

评估原发性乳腺癌的临床病理因素和影像学特征在预测初次治疗后早期复发中的价值。

材料与方法

我们纳入了2010年1月至2014年12月在我院接受保乳手术及辅助治疗后进行随访的480例患者。早期复发定义为初次治疗完成后3年内复发,进行单因素和多因素逻辑回归分析以确定早期复发的临床病理和影像学预测因素。

结果

在单因素分析中,临床病理因素中,晚期(P = 0.021)、高组织学分级(P < 0.001)、雌激素受体阴性(P = 0.002)、高Ki-67增殖指数(P = 0.017)和三阴性乳腺癌(P = 0.019),以及影像学特征中,多灶性(P < 0.001)、多普勒超声(US)边缘血管(P = 0.012)和乳腺磁共振成像上的边缘强化(P < 0.001)与早期复发显著相关。在多因素分析中,晚期[比值比(OR)= 3.47;95%置信区间(CI)1.12 - 10.73;P = 0.031]和多普勒超声边缘血管(OR = 3.32;95% CI 1.38 - 8.02;P = 0.008)是早期复发的独立预测因素。

结论

治疗前多普勒超声显示原发性乳腺癌边缘的血管情况是初次治疗后早期复发的影像学独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31d1/9431821/fab1af88044d/jksr-81-395-g001.jpg

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