苏泽珍,李蔓英,黄彩欣,罗佳,梁瑾瑜,潘福顺,郑艳玲,谢晓燕.超声联合免疫组织化学指标预测新辅助化疗后乳腺癌转移性腋窝淋巴结病理完全缓解[J].中国医学影像技术,2022,38(3):379~383
超声联合免疫组织化学指标预测新辅助化疗后乳腺癌转移性腋窝淋巴结病理完全缓解
Ultrasound combined with immunohistochemical indexes for predicting pathological complete response of metastatic axillary lymph nodes of breast cancer after neoadjuvant chemotherapy
投稿时间:2020-03-31  修订日期:2022-01-04
DOI:10.13929/j.issn.1003-3289.2022.03.014
中文关键词:  乳腺肿瘤  淋巴结转移  新辅助治疗  病理完全缓解  超声检查
英文关键词:breast neoplasms  lymphatic metastasis  neoadjuvant therapy  pathological complete response  ultrasonography
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作者单位E-mail
苏泽珍 中山大学附属第一医院超声医学科, 广东 广州 510080
南方医科大学珠江医院超声医学科, 广东 广州 510280 
 
李蔓英 中山大学附属第一医院超声医学科, 广东 广州 510080  
黄彩欣 中山大学附属第一医院超声医学科, 广东 广州 510080  
罗佳 中山大学附属第一医院超声医学科, 广东 广州 510080  
梁瑾瑜 中山大学附属第一医院超声医学科, 广东 广州 510080  
潘福顺 中山大学附属第一医院超声医学科, 广东 广州 510080  
郑艳玲 中山大学附属第一医院超声医学科, 广东 广州 510080 zhyanl@mail.sysu.edu.cn 
谢晓燕 中山大学附属第一医院超声医学科, 广东 广州 510080  
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中文摘要:
      目的 观察超声联合免疫组织化学指标预测新辅助化疗(NACT)后乳腺癌转移性腋窝淋巴结病理完全缓解(pCR)的价值。方法 纳入155例接受NACT的乳腺癌伴腋窝淋巴结转移患者,根据腋窝淋巴结清扫(ALND)术后病理结果将其分为pCR组(n=59)及非pCR组(n=96);比较2组NACT前免疫组织化学指标及乳腺癌病灶及腋窝淋巴结的超声特征,建立logistic预测模型,观察其预测NACT后腋窝淋巴结pCR的价值。结果 2组乳腺癌原发灶Ki-67表达、人表皮生长因子受体2(HER-2)表达及腋窝转移性淋巴结短径、最大皮质厚度和形态差异均有统计学意义(P均<0.05)。logistic预测模型预测NACT后乳腺癌腋窝转移性淋巴结pCR的AUC为0.734,敏感度为42.37%(25/59),特异度为84.38%(81/96)。结论 NACT前超声联合免疫组织化学预测NACT后乳腺癌转移性腋窝淋巴结pCR具有一定价值。
英文摘要:
      Objective To observe the value of ultrasound combined with immunohistochemical indexes for predicting pathological complete response (pCR) of metastatic axillary lymph nodes of breast cancer after neoadjuvant chemotherapy (NACT). Methods Totally 155 breast cancer patients with axillary lymph node metastasis who then underwent NACT were enrolled and divided into pCR group (n=59) and non-pCR group (n=96) according to the pathological results after axillary lymph node dissection (ALND). The immunohistochemical indexes and ultrasonic characteristics of primary breast cancer and metastatic axillary lymph nodes before NACT were compared between groups. Then logistic prediction model was established, and its value for predicting metastatic axillary lymph node pCR after NACT was observed. Results There were significant differences of Ki-67, human epidermal growth factor receptor-2 (HER-2) of primary breast cancer, as well as the short diameter, the maximum cortical thickness and the morphologies of metastatic axillary lymph nodes between groups (all P<0.05). The area under the curve (AUC), the sensitivity and specificity of logistic prediction model for predicting pCR of metastatic axillary lymph nodes after NACT were 0.734, 42.37% (25/59) and 84.38% (81/96), respectively. Conclusion Ultrasound combined with immunohistochemistry before NACT had certain value for predicting pCR of metastatic axillary lymph nodes of breast cancer after NACT.
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