影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (2): 307-312.DOI: 10.7517/issn.1674-0475.190919

• 综述与论文 • 上一篇    下一篇

磁共振扩散加权成像(DWI)评估进展期乳腺癌患者新辅助化疗近期疗效及病理变化的价值研究

佟颖1, 米楠1, 张荣2, 邢千超1, 杨岳云1, 王胜林1   

  1. 1. 承德医学院附属医院, 河北 承德 067000;
    2. 承德医学院, 河北 承德 067000
  • 收稿日期:2019-09-19 出版日期:2020-03-15 发布日期:2020-03-15
  • 基金资助:
    2015年度河北省医学科学研究重点课题计划(20150483)资助

Evaluation of Short-term Efficacy of Neoadjuvant Chemotherapy and Pathological Changes in Patients with Advanced Breast Cancer by DWI

TONG Ying1, MI Nan1, ZHANG Rong2, XING Qianchao1, YANG Yueyun1, WANG Shenglin1   

  1. 1. Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei, P. R. China;
    2. Chengde Medical College, Chengde 067000, Hebei, P. R. China
  • Received:2019-09-19 Online:2020-03-15 Published:2020-03-15
  • Supported by:
     

摘要: 为探究磁共振扩散加权成像(diffusion weighted imaging,DWI)检查结果与局部进展期乳腺癌新辅助化疗疗效的相关性,为局部进展期乳腺癌预后判断提供影像学依据,本文纳入2016年2月~2017年2月于我院进行新辅助化疗治疗的72例进展期乳腺癌患者,根据化疗疗效分为有效组与无效组,根据不同病理反应性分级分为组织学非显著反应(NMHR)组与组织学显著反应(MHR)组,比较了治疗前后各组弥散系数(ADC)值,并对肿瘤体积减少值与ADC增加值进行了相关性分析。结果显示72例进展期乳腺癌患者经新辅助化疗治疗有效45例,有效率为62.50%,无效27例,无效率为37.50%。治疗后MHR组43例,NMHR组29例,有效组治疗后肿瘤体积显著小于无效组,MHR组治疗后肿瘤体积显著小于NMHR组,差异具有统计学意义(P<0.05)。有效组与无效组、NMHR组与MHR组治疗前ADC值差异无统计学意义(P>0.05),治疗后均显著升高,但有效组显著高于无效组,MHR组显著高于NMHR组,差异具有统计学意义(P<0.05);组间ADC值增加值比较,差异具有统计学意义(P<0.05)。肿瘤体积与ADC值呈负相关,瘤体积减少值与ADC增加值呈正相关。本研究表明DWI的ADC值与进展期乳腺癌患者肿瘤体积呈负相关,ADC值可有效评估新辅助化疗近期疗效和病理变化。

 

关键词: 磁共振扩散加权成像, 局部进展期乳腺癌, 新辅助化疗, 疗效, 相关性

Abstract: In this study, to investigate the correlation between the result of diffusion weighted imaging (DWI) and neoadjuvant chemotherapy in locally advanced breast cancer, and to provide the imaging basis for the prognosis of locally advanced breast cancer, 72 patients with advanced breast cancer who underwent neoadjuvant chemotherapy in our hospital from February 2016 to February 2017 were divided into effective group and ineffective group according to the curative effect of chemotherapy. And patients were also divided into non-major histological response (NMHR) group and major histological response (MHR) group according to the pathological reactivity. Then the values of ADC before and after treatment were compared, and the correlation between tumor volume reduction and ADC value was analyzed. In 72 cases of advanced breast cancer patients treated with neoadjuvant chemotherapy, the treatment were effective in 45 cases. The effective rate is 62.50% (45/72), and the ineffectiveness rate was 37.50% (27/72). After the chemotherapy, there were 43 cases of MHR and 29 cases of NMHR. The tumor volume in the effective group was significantly smaller than that in the ineffective group, and the tumor volume in the MHR group was significantly smaller than that in the NMHR group (P<0.05). The ADC value of the four groups before treatment showed no significant difference (P>0.05), and were all increased after treatment. Moreover, the ADC value of effective group and MHR group were higher than that in the ineffective group and NMHR group respectively (P<0.05). The added ADC value between groups showed a significant difference (P<0.05). Tumor volume was negatively correlated with ADC value, and tumor volume reduction value was positively correlated with the ADC added value. This study showed that the ADC value of DWI was negatively correlated with the tumor volume in patients with advanced breast cancer, which can effectively evaluate the short-term efficacy and pathological changes of neoadjuvant chemotherapy.

Key words: DWI, locally advanced breast cancer, neoadjuvant chemotherapy, efficacy, correlation

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