在乳腺癌患者的新辅助系统治疗后,与节点阳性相关的因素,这些患者最初在MRI上是节点负的
B Bersu Ozcan1, Firouzeh K Arjmandi1, Dogan S Polat1
1Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Annals of surgical oncology
|February 13, 2025
概括
在乳腺癌患者中,最初MRI上的节点阴性,13.9%在新辅助全身疗法 (NST) 后出现了阳性状淋巴结. 分子亚型,特别是三阴性,影响了这些结果,突出了需要准确的节点分期.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 病理学 病理学 病理学
背景情况:
- 评估下淋巴结状况对于乳腺癌治疗计划至关重要.
- 新辅助全身疗法 (NST) 可以改变结节阶段.
- 动态对比增强型MRI用于初始节点分期 (cN0).
研究的目的:
- 在cN0患者中确定NST后阳性下淋巴结 (ypN+) 的速率.
- 确定预测ypN+状态的临床病理因素.
主要方法:
- 对194名侵袭性乳腺癌患者 (MRI上的cN0) 以NST治疗的回顾性分析.
- 记录了临床病理特征,分子亚型和成像结果.
- 使用LASSO回归,开发了一种股转移的预测模型.
主要成果:
- 13.9%的患者在NST后患有ypN+疾病 (中位数为1个转移节点).
- 三重阴性亚型与HER2+ (11.8%) 和HR+ (25.0%) 亚型相比,显示出明显较低的ypN+率 (4.8%).
- 预测模型的表现适度 (AUC:0.62).
结论:
- 在cN0乳腺癌患者中,显著的比例在NST后发展为ypN+疾病.
- 分子亚型是残留结节疾病的重要预测因素.
- 在NST后准确的节点分期仍然是一个挑战.
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