健侧乳腺MRI背景实质强化与新辅助化疗后肿瘤反应的相关性

目的 探讨乳腺癌新辅助化疗（NAC）后健侧乳腺MRI背景实质强化（BPE）与肿瘤反应的相关性。方法 回顾性分析129例乳腺癌患者健侧乳腺NAC前后BPE差异，比较病理完全缓解（pCR）组与非pCR组、绝经前组（70例）与绝经后组（59例）患者基线BPE差异及NAC后各组间BPE差异，分析影响疗效的相关因素及BPE水平与腺体密度的相关性。结果 pCR组（31例）和非pCR组（98例）NAC后BPE均低于NAC前（P均<0.01），组间基线BPE差异无统计学意义（P=0.99）；2组NAC后BPE差异有统计学意义（P=0.01），NAC后pCR组BPE下降比非pCR组更显著（P<0.01）。绝经前组患者基线BPE及NAC后BPE均高于绝经后组（P均<0.01），绝经前组NAC后BPE下降更显著（P<0.01）。NAC后低BPE、雌激素受体（ER）/孕激素受体（PR）阴性患者更易达到pCR （P<0.01）。腺体密度与BPE间无明显相关（P>0.05）。结论 乳腺癌NAC后健侧乳腺BPE降低可作为评价NAC有效性的指标。ER/PR阴性肿瘤患者比ER/PR阳性肿瘤患者更易实现pCR。

Correlation between MRI background parenchymal enhancement and tumor response in healthy breast after neoadjuvant chemotherapy

Objective To explore the correlation between background parenchymal enhancement (BPE) and tumor response in healthy breast after neoadjuvant therapy (NAC). Methods Differences of BPE before and after NAC in 129 patients with breast cancer were retrospectively analyzed. The differences of baseline BPE between patients with pathological complete remission (pCR) and non-pCR group, premenopausal group (n=70) and postmenopausal group (n=59), as well as the differences of BPE between groups after NAC were compared. The correlation between BPE level and gland density was analyzed. Results BPE after NAC was lower than that before NAC in pCR group and non-pCR group (both P<0.01).There was no significant difference of baseline BPE between the above 2 groups (P=0.99), while there was significant difference of BPE between these 2 groups after NAC (P=0.01), and decrease of BPE after NAC in PCR group was more significant than in non-pCR group (P<0.01). The baseline BPE and post NAC BPE in premenopausal group were higher than those in postmenopausal group (both P<0.01), and the decrease of BPE in premenopausal group was more significant than that in postmenopausal group (P<0.01). Patients with lower BPE after NAC, negative estrogen receptor (ER)/progesterone receptor (PR) were more likely to achieve pCR (both P<0.01). There was no correlation between gland density and BPE (P>0.05). Conclusion The decrease of BPE in contralateral breast after NAC could be used as an indicator of effectiveness of NAC for breast cancers. Patients with ER/PR negative tumor were more likely to achieve pCR than ER/PR positive tumor.