摘要
目的通过乳腺磁共振成像(MRI)技术评估新辅助化疗(NAC)对乳腺癌的疗效,并探讨MR多参数成像对浸润性乳腺癌肿瘤浸润淋巴细胞(TILs)的预测价值。方法将本院2020年2月至2021年8月收治的浸润性乳腺癌患者142例纳入本次研究中,按照不同治疗方式分为NAC组(n=68)及常规组(n=74)。比较治疗前后两组乳腺MRI成像参数及治疗后两组患者TILs水平;根据治疗前的TILs比例将所有病例分为TILs低比例组、TILs高比例组,评估MR多参数对浸润性乳腺癌TILs水平高低的诊断价值。结果研究组治疗后ADC显著升高,肿瘤中心层面最大直径明显下降(P<0.05);研究组治疗有效率显著高于常规组(P<0.05);治疗后研究组TILs水平明显比常规组高(P<0.05);TILs高比例组中Her-2过表达型、三阴型数量多于低比例组;比较MRI参数发现,乳腺癌的形状、边缘、脂肪抑制T2WI信号均匀度、内部强化方式差异明显(P<0.05),形状圆形或卵圆形、边缘光滑、脂肪抑制T2WI信号均匀、内部强化均匀可能为TILs高表达相关(P<0.05);形状、边缘、脂肪抑制T2WI信号均匀度、内部强化方式ROC曲线线下面积均较高,且具有较高的特异性及敏感度。结论采用NAC治疗乳腺癌患者,可缩小病灶,使TILs表达增加,有利于患者病情稳定或改善,且通过MR多参数成像可对乳腺癌患者TILs水平起到预测作用,更好指导患者预后,建议临床推广使用。
Objective To evaluate the efficacy of neoadjuvant chemotherapy(NAC)in breast cancer by breast magnetic resonance imaging(MRI),and to explore the predictive value of MR multiparameter imaging for tumor-infiltrating lymphocytes(TILs)in invasive breast cancer.Methods 142 patients with invasive breast cancer admitted to our hospital from February 2020 to August 2021 were included in this study,and divided into NAC group(n=68)and conventional group(n=74)according to different treatment methods.Breast MRI parameters before and after treatment and TILs level after treatment were compared between the two groups.Before treatment,all cases were divided into TILs low proportion group and TILs high proportion group according to TILs proportion,and the diagnostic value of MR multiple parameters on TILs level of invasive breast cancer was evaluated.Results After treatment,ADC in the study group significantly increased,the maximum diameter of the tumor center layer significantly decreased(P<0.05);The effective rate of treatment in the study group was significantly higher than that in the control group(P<0.05);After treatment,the level of TILs in the experimental group was significantly higher than that in the control group(P<0.05);The number of Her-2 overexpression type and triple negative type in the high proportion of TILs group was more than that in the TILS low proportion group;Comparing MRI parameters,it found that there were significant differences in the shape,edge,fat-suppressed T2WI signal uniformity and internal enhancement pattern of breast cancer(P<0.05).It related to the high expression of TILs(P<0.05);The shape,edge,fatsuppressed T2WI signal uniformity,and area under the ROC curve of the internal enhancement method were all higher,and had higher specificity and sensitivity.Conclusion The use of NAC in the treatment of breast cancer patients can reduce the lesions and increase the expression of TILs,which is beneficial to the stability or improvement of the patient's condition.MR multi-parameter imaging can predict
作者
贺松
李娇娇
张斌
陈静
刘迪
史新乐
He Song;Li Jiao-jiao;Zhang Bin;Chen Jing;Liu Di;Shi Xin-le(The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei Province,China)
出处
《中国CT和MRI杂志》
2023年第7期87-89,92,共4页
Chinese Journal of CT and MRI
基金
河北省医学科学研究课题(20210136)。
