在乳腺癌患者完成新辅助化疗后使用乳腺MRI预测病理完整反应,乳腺癌患者在乳腺扫描上有残留形
Ga Eun Park1, Seungsoo Lee2, Eun Jeong Min3
1Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
磁共振成像 (MRI) 响应和分子亚型预测乳腺癌患者的病理完整响应 (pCR),这些患者在新辅助化疗 (NAC) 后有残留化. 建议进行外科切除,因为MRI在亚型中的准确度可变.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 乳腺癌的新辅助化疗 (NAC) 可以在乳房镜上留下残留的可疑化,使手术策略复杂化.
- 这些化通常不管瘤活力如何,都会持续存在,这构成了诊断挑战.
研究的目的:
- 在乳腺癌患者中确定病理完整反应 (pCR) 的预测因子,这些患者在NAC后残留可疑化.
- 为了评估这个患者群体的最佳外科手术方法.
主要方法:
- 对243名乳腺癌患者的回顾性分析,在NAC后残留可疑化和MRI (CR或PR) 上的放射性反应.
- 两位失明的放射科医生评估的乳房影像和MRI发现.
- 分子亚型 (HR+/HER2-, HR+/HER2+, HR-/HER2+, TNBC) 分类. 分类.
- 多变量回归与弹性网惩罚用于找到pCR预测因子.
主要成果:
- 总体PCR率为33.7%,为33.7%.
- 在MRI (OR,3.13;P=0.015) 和HR-/HER2+亚型 (OR,29.7;P=0.005) 上的完整反应是显著的pCR预测指标.
- 根据亚型,MRI诊断性能有所不同:TNBC (87%) 的灵敏度最高,HR+/HER2- (100%) 的特异性最高,HR+/HER2- (80.8%) 和TNBC (78.9%) 的精度最高.
结论:
- 治疗后的MRI反应和分子亚型显著预测乳腺癌患者的pCR,在NAC后残留化.
- 建议进行完整的外科切除,特别是HR+/HER2- (最低PCR) 和HR-/HER2+ (低于最佳MRI准确度) 亚型.
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