超声在乳腺癌新辅助化疗疗效评估中的应用价值

摘要

目的 分析乳腺癌新辅助化疗(NAC)前后的声像图变化,探讨超声评估乳腺癌NAC疗效的应用价值.方法 回顾性分析81例乳腺癌患者(共87个病灶)NAC前、NAC 2个周期后及4个周期后的二维和彩色多普勒超声表现.以病灶最大径线和血流等级作为NAC后评价的有效指标,评估其临床疗效.将超声检查结果与病理结果进行对比,分析超声的诊断价值.结果 与NAC前比较,NAC 2个周期及4个周期后病灶血流丰富程度显著降低甚至消失,最大流速和阻力指数均显著下降,差异均有统计学意义(均P<0.05).NAC后术前超声评价完全缓解9个,部分缓解55个,稳定17个,进展6个.超声评价的准确率为80.5%,敏感性为89.8%,特异性为60.7%.结论 超声对乳腺癌NAC疗效有重要评估价值,NAC前后以最大径线和血流等级作为评效指标对于NAC治疗效果有重要指导价值.%Objective To analyze the sonographic changes of breast cancer before and after neoadjuvant chemotherapy (NAC),and to explore the value of ultrasound in the evaluation of NAC.Methods Two-dimensional and color Doppler ultrasonographic findings of 81 cases of breast cancer(87 lesions) before and after 2 cycles and 4 cycles of NAC were analyzed retrospectively.The therapeutic effect of NAC was evaluated by taking the maximum diameter and the grade of blood flow as the effective indexes of NAC.The diagnostic value of ultrasound was analyzed by comparing the results with those of pathology. Results Compared with the results before NAC,the blood flow signals in the lesions were decreased significantly or even disappeared,Vmax and RI were decreased significantly after 2 cycles and 4 cycles of NAC,the difference was statistically significant(all P<0 . 05). After NAC , the results of preoperative ultrasound evaluation showed complete remission in 9 lesions , partial remission in 55 lesions,stable in 17 lesions and progress in 6 lesions.The accuracy of ultrasound evaluation was 80.5%,the sensitivity was 89.8%,and the specificity was 60.7%.Conclusion Ultrasound has important value in evaluation of the therapeutic effect of NAC.Before and after NAC,the maximum diameter and the blood flow level are important evaluation indexes,which have important guiding value for therapeutic effect of NAC.