摘要
目的探讨乳腺癌新辅助治疗中期多点粗针穿刺预测疗效的可行性。方法选取2021年3月至2022年11月有新辅助治疗指征67例乳腺癌为研究对象,于新辅助治疗第4周期行肿瘤床3、6、9、12点及残瘤灶粗针穿刺,将粗针穿刺结果与新辅助治疗完成后手术常规病理匹配比较,分析中期病理评估与术后常规病理一致性和假阴性率(false negative rate,FNR),验证中期多点粗针穿刺病理评估的可行性。结果入组患者中位年龄49.2岁(21~69岁);新辅助治疗前肿瘤中位最大径与新辅助治疗后残余肿瘤中位最大径分别为40.4 mm(21~93 mm)和19.6 mm(0~41 mm)。28例患者获得病理完全缓解(pathologic complete response,pCR)(41.8%),激素受体(hormone receptor,HR)(+)人表皮生长因子受体2(human epidermal growth factor receptor-2,HER2)(-)、HR(-)HER2(-)、HR(-)HER2(+)及HR(+)HER2(+)分子亚型pCR率分别为4/24(16.7%)、6/14(42.9%)、11/18(61.1%)、7/11(63.6%)。2.9%(2/67)术前影像学检查无异常。残瘤灶中期粗针穿刺病理与手术后常规病理一致率82.1%(55/67)。瘤床中期粗针穿刺病理与手术后常规病理一致率83.6%(56/67)。残瘤灶中期多点粗针穿刺病理FNR为17.9%(12/67)。瘤床中期粗针穿刺病理FNR约5.9%(4/67)。结论乳腺癌新辅助治疗中期采用多点粗针穿刺预测残瘤灶、瘤床的肿瘤退缩状态是可行的。改善穿刺技能可提高多点粗针穿刺病理评估的准确性。
Objective To investigate the feasibility of multipoint core needle biopsy(CNB)at mid-stage to predict the treatment effect of neoadjuvant systemic therapy for breast cancer.Methods A total of 67 breast cancer cases with indications of neoadjuvant systemic therapy were selected from Mar.2021 to Nov.2022.In the fourth cycle of neoadjuvant systemic therapy,core needle biopsy was performed at 3,6,9,12 points of tumor bed and residual tumor foci of breast respectively.The results of CNB were compared with the results of routine pathology of surgery after the completion of neoadjuvant therapy.Matched biopsy and surgical specimens were compared to assess pCR.The accuracy and false negative rate(FNR)of interim pathological assessment were analyzed.The coincidence probability of interim biopsy pathology and pathology of standard surgical excision was verified.Results The median age of enrolled patients was 49.2 years(21-69 years).Median maximum tumor diameter before neoadjuvant systemic therapy and residual tumor diameter after neoadjuvant therapy were 40.4 mm(range 21-93mm)and 19.6 mm(range 0-41mm)respectively.A total of 28 patients achieved pCR,and the PCR rates of hormone receptor-positive and HER2-nagative,triple-negative,hormone receptor negative and HER2-positive and hormone receptor-positive and HER2-positive disease were 4/24(16.7%),6/14(42.9%),11/18(61.1%),7/11(63.6%),respectively.Two cases had no preoperative imaging abnormalities.The results of core needle biopsy pathology of residual tumor lesions in 55 patients were consistent with those of routine post-operation pathology.The results of core needle biopsy pathology of tumor bed of 56 patients was consistent with the routine pathology of surgery.The false negative rate of interim multipoint biopsy pathology of residual tumor foci was 17.9%(12/67).The false negative rate of tumor bed with core needle biopsy was 5.9%(4/67).Conclusions CNB guided under ultrasound is feasible in predicting tumor retreat situation in the tumor bed area and residual tumor foci at m
作者
洪士开
王舒晗
朱正志
刘建军
任扩军
王圣应
Hong Shikai;Wang Shuhan;Zhu Zhengzhi;Liu Jianjun;Ren Kuojun;Wang Shengying(Department of Head-Neck and Breast Surgery,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China)
出处
《中华内分泌外科杂志》
CAS
2023年第5期524-529,共6页
Chinese Journal of Endocrine Surgery
基金
国家自然科学基金青年科学基金(81802641)。
关键词
乳腺癌
新辅助治疗
体表纹身
多点粗针穿刺
病理
Breast cancer
Neoadjuvant therapy
Body surface tattoo
Multiple core needle biopsy
Pathology
