摘要
目的病理学检查并不能为乳腺癌患者化疗后的病灶变化提供依据,因此本研究旨在探讨彩色超声在乳腺癌患者新辅助化疗中的临床应用价值。方法选取2014年4月—2016年8月于丽水市中心医院进行治疗的乳腺癌患者84例,分别于新辅助化疗前、化疗3个周期后进行彩色超声检查,比较化疗前、后病灶变化及病灶内和腋窝异常淋巴结内血流动力学指标变化。结果彩色超声显示,与新辅助化疗前相比,化疗后乳腺癌患者病灶体积明显减少(P<0.01),病灶形态、边界、周边声带、周边强回声、血流分级均存在明显变化(P<0.05);以病理学评价为金标准,彩色超声检查病灶变化的灵敏度为83.02%,特异度为63.96%;与病理学评价的一致性Kappa值=0.390,P<0.01;与新辅助化疗前相比,有效组(完全缓解+部分缓解)化疗后病灶内血管最丰富断面血流动力学指标最高流速(Vmax)、阻力指数(RI)均明显降低(P<0.01),无效组(稳定+进展)Vmax、RI无明显变化(P>0.05),且化疗后有效组Vmax、RI明显低于无效组(P<0.01);与新辅助化疗前相比,有效组化疗后腋窝异常淋巴结内血管最丰富断面Vmax、RI均明显降低(P<0.01),无效组Vmax、RI无明显变化(P>0.05),且化疗后有效组Vmax、RI明显低于无效组(P<0.01)。结论彩色超声对乳腺癌新辅助化疗效果评价具有一定的临床应用价值。
Objective The pathological examination did not provide the basis of lesion changes after chemotherapy in patients with breast cancer. The aim of this paper is to investigate the clinical application value of color ultrasound in breast cancer patients with neo-adjuvant chemotherapy. Methods A total of 84 breast cancer patients were selected in our hospital from April,2014 to August,2016. All of breast cancer patients received treatment with neo-adjuvant chemotherapy.To compare lesion changes,hemodynamic index changes of lesion and hemodynamic index changes of abnormal axillary lymph nodes before and after chemotherapy. Results After the neo-adjuvant chemotherapy,the lesion volume decreased significantly（ P〈0. 01）,there was significant difference on lesion morphology,border,peripheral vocal cords,peripheral echo and blood flow classification（ P〈0. 05）; The pathological evaluation as the gold standard,the sensitivity was83. 02%,the specificity was 63. 96% through color ultrasound; consistency of pathological evaluation and color ultrasound： Kappa = 0. 390,P〈0. 01; When compared with the values before neo-adjuvant chemotherapy,Vmax and RI of the richest Blood vessels section of lesion decreased significantly in the effective（ CR ＋ PR） group（ P〈0. 01）,there was no significant difference on Vmax and RI in the invalid（ SD ＋ PD） group（ P〉0. 05）,and Vmax and RI of the effective group was significantly lower than those in the invalid group（ P〈0. 01）; After the neo-adjuvant chemotherapy,Vmax and RI of the richest Blood vessels section of abnormal axillary lymph nodes decreased significantly in the effective group（ P〈0. 01）,there was no significant difference on Vmax and RI in the invalid group（ P〈0. 05）,and Vmax and RI of the effective group was significantly lower than those in the invalid group（ P〈0. 01）. Conclusion Color ultrasound can provide a valuable method for the assessment of efficacy in breast cancer patients with neo-adjuvant chemotherapy.
出处
《中华全科医学》
2017年第4期647-649,共3页
Chinese Journal of General Practice
关键词
彩色超声
乳腺癌
新辅助化疗
Color Doppler ultrasound
Breast cancer
Neo-adjuvant chemotherapy
