超声结合钼靶成像及Ki-67表达对乳腺癌新辅助化疗疗效的预测价值

目的 探讨常规超声、钼靶X线影像学特征及Ki-67阳性表达率对乳腺癌新辅助化疗后达到病理完全缓解(pCR)的预测价值.方法 回顾性选取2014年11月至2019年11月在常州市第二人民医院行新辅助化疗治疗的68例乳腺癌患者,患者行化疗前均接受乳腺超声和钼靶X线检查,且均经粗针穿刺取得病理和免疫组化结果.依据新辅助化疗疗...

Value of ultrasonography combined with mammographic features and Ki-67 index in predicting efficacy of neoadjuvant chemotherapy for breast cancer

ObjectiveTo assess the value of ultrasound combined with mammographic features and Ki-67 index in predicting the efficacy of neoadjuvant chemotherapy for breast cancer. MethodsSixty-eight patients with breast cancer who received neoadjuvant chemotherapy at Changzhou Second People's Hospital from November 2014 to November 2019 were examined by ultrasonography and mammography before chemotherapy. Pathological and immunohistochemically results were obtained by biopsy. According to the efficacy of neoadjuvant chemotherapy, the patients were divided into either a pathologic complete response (pCR) group or a non-pCR group. Univariate and multivariate Logistic regression analyses were performed to analyze the independent predictors of pCR after neoadjuvant chemotherapy for breast cancer. ResultsOf the 68 patients ,12 achieved pCR and 56 did not, with a pCR rate of 17.6%. The statistically significant parameters identified in the univariate analysis, such as the type of posterior echo of tumor, the edge characteristics of tumor in mammography, and the positive expression rate of Ki-67 or estrogen receptor (ER), were included in binary logistic regression for multivariate analysis. The results showed that absence of posterior shadowing on ultrasound (odds ratio [OR]=0.045, 95% CI: 0.005-0.453), absence of mammographic spiculation (OR=0.128, 95% CI: 0.023-0.720), and high Ki-67 expression (OR=0.045, 95% CI: 0.004-0.546)were independent predictors of pCR. ConclusionThe absence of posterior shadowing on ultrasound, absence of mammographic speculation, and high Ki-67 high could predict the degree of pathological remission in breast cancer patients after neoadjuvant chemotherapy. Preoperative imaging examination and immunohistochemical Ki-67 detection have appreciated guiding significance for the selection of clinical treatment for breast cancer.