Liu Yan, Li Wenxiao, Wang Sirui, Wang Jinli, Yuan Xiaowu, Deng Yaqian, Xu Zelin, Hou Jixue, Li Jun, Song Tao
Department of Ultrasound, the First Affiliated Hospital of Shihezi University, Shihezi, China.
Department of Thyroid and Breast Surgery, the First Affiliated Hospital of Shihezi University, Shihezi, China.
Quant Imaging Med Surg. 2025 Sep 1;15(9):8333-8347. doi: 10.21037/qims-2024-2730. Epub 2025 Aug 15.
Neoadjuvant chemotherapy (NAC) is administered to specific subgroups of breast cancer patients to improve clinical outcomes. Achieving a pathological complete response (pCR) is strongly associated with improved survival. This meta-analysis systematically evaluated the diagnostic performance of shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) in predicting the pathological response of breast cancer patients to NAC.
Relevant studies were searched in the databases of PubMed, Web of Science, and Embase until July 14, 2024. The articles were screened and relevant data were extracted, and study quality was assessed using Review Manager 5.4. The area under the curve (AUC) was calculated, and publication bias was evaluated by funnel plots generated using Stata 18.0. These analyses aimed to assess the diagnostic performance of SWE and CEUS in predicting the pathological response of breast cancer patients to NAC in terms of sensitivity (Sen) and specificity (Spe).
A total of 22 studies comprising 1,725 breast cancer patients were included in the meta-analysis. The composite combined AUC, Sen, and Spe of CEUS in monitoring the pathological response of breast cancer patients to NAC were 0.86 [95% confidence interval (CI), 0.83-0.89], 0.88 (95% CI, 0.80-0.93), and 0.80 (95% CI, 0.74-0.84), respectively, and those of SWE were 0.88 (95% CI, 0.84-0.90), 0.82 (95% CI, 0.77-0.85), and 0.81 (95% CI, 0.74-0.86), respectively.
This meta-analysis confirmed that CEUS and SWE had comparable Spe in predicting the pathological response of breast cancer patients to NAC (CEUS: 0.80 SWE: 0.81), but CEUS had superior Sen (0.88 0.82). Both modalities have clinically relevant diagnostic value (AUC >0.80), supporting their utility in the non-invasive monitoring of NAC efficacy.
新辅助化疗（NAC）应用于特定亚组的乳腺癌患者以改善临床结局。实现病理完全缓解（pCR）与生存率提高密切相关。本荟萃分析系统评价了剪切波弹性成像（SWE）和超声造影（CEUS）在预测乳腺癌患者对NAC的病理反应方面的诊断性能。
在PubMed、Web of Science和Embase数据库中检索截至2024年7月14日的相关研究。筛选文章并提取相关数据，使用Review Manager 5.4评估研究质量。计算曲线下面积（AUC），并使用Stata 18.0生成的漏斗图评估发表偏倚。这些分析旨在从敏感性（Sen）和特异性（Spe）方面评估SWE和CEUS在预测乳腺癌患者对NAC的病理反应方面的诊断性能。
荟萃分析共纳入22项研究，涉及1725例乳腺癌患者。CEUS监测乳腺癌患者对NAC病理反应的综合合并AUC、Sen和Spe分别为0.86[95%置信区间（CI），0.83 - 0.89]、0.88（95%CI，0.80 - 0.93）和0.80（95%CI，0.74 - 0.84），SWE的分别为0.88（95%CI，0.84 - 0.90）、0.82（95%CI，0.77 - 0.85）和0.81（95%CI，0.74 - 0.86）。
本荟萃分析证实，在预测乳腺癌患者对NAC的病理反应方面，CEUS和SWE具有相当的Spe（CEUS：0.80，SWE：0.81），但CEUS具有更高的Sen（0.88对0.82）。两种方法均具有临床相关的诊断价值（AUC>0.80），支持它们在NAC疗效无创监测中的应用。
