摘要
目的探讨自动乳腺全容积成像(ABVS)在乳腺癌新辅助化疗(NAC)疗效评估中的价值。方法回顾性分析2012年1月至2018年12月浙江大学医学院附属杭州市第一人民医院术前行NAC并最终行手术治疗的乳腺癌患者83例,共89个肿块,测量NAC前后肿块的最大径线值D1和D2,并计算其变化率ΔD=(D1-D2)/D1×100%,通过ΔD对NAC疗效进行评估,并与术后病理评估结果对照。结果ABVS及病理两种方法评估NAC无效的一致性较好,Kappa值为0.772(P=0.000);评估部分缓解的一致性中等,Kappa值为0.519(P=0.000);评估完全缓解的一致性较差,Kappa值为0.294(P=0.000)。当以ΔD≥70%评估完全缓解时,与病理评估具有较好的一致性,Kappa值为0.876(P=0.000),其灵敏度为0.867,特异度为0.986。结论ABVS评估乳腺癌NAC疗效与病理评估具有较好的一致性,可作为乳腺癌NAC疗效评估的一种新方法,但建议评估完全缓解的ΔD阈值应为70%。
Objective To assess the application of automated breast volume scanner(ABVS)for evaluation neoadjuvant chemotherapy(NAC)response in breast cancer patients.Methods Clinical data and ABVS findings of 89 patients with breast carcinoma undergoing NAC before surgery were retrospectively analyzed.The longest diameter of tumor on ABVS was measured before(D1)and after(D2)NAC,the rate of changeΔD=(D1-D2)/D1×100%was calculated.With postoperative pathological results as gold standard,the value ofΔD for NAC response was analyzed.Results The consistency of ABVS with pathological results in patients with NAC ineffectiveness was good(κ=0.772,P=0.000),the consistency in patients with partial response was modest(κ=0.519,P=0.000),and the consistency in patients with complete response was poor(κ=0.294,P=0.000).WhenΔD≥70%,the consistency of the two methods for evaluating complete response was satisfactory(κ=0.876,P=0.000)with a sensitivity of 0.867 and specificity of 0.986.Conclusion ABVS can be used to evaluate the NAC response for breast cancer;when the threshold ofΔD=70%,it is recommended to evaluate the complete response to NAC.
作者
刘小明
包凌云
谭艳娟
牛琳
王炜
LIU Xiaoming;BAO Lingyun;TAN Yanjuan;NIU Lin;WANG Wei(Department of Ultrasonography,Affiliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China)
出处
《浙江医学》
CAS
2020年第14期1489-1491,I0003,共4页
Zhejiang Medical Journal
基金
浙江省医药卫生科技计划项目(2019PY061)。
关键词
乳腺癌
新辅助化疗
自动乳腺全容积成像
Breast carcinoma
Neoadjuvant chemotherapy
Automated breast volume scanner
