【摘要】 目的:探讨增强磁共振成像(MRI)病灶-背景实质信号增强比(LBSER)预测乳腺癌新辅助化疗(NAC)后病理性完全缓解(pCR)的价值。方法:选取我院2008年1月至2016年12月行NAC及增强MRI检查的乳腺癌患者136例。记录患者临床病理特征、MRI测量肿瘤大小、MRI图像LBSER值。采用多因素和单因素Logistic回归分析预测pCR的因素。采用受试者工作特征(ROC)曲线分析相关因素预测pCR的价值。结果:单因素Logistic回归分析表明三阴型乳腺癌、MRI增强早期LBSER、MRI增强延迟期LBSER、MRI增强早期微小残余癌(MRC)大小、MRI延迟期MRC大小和MRI延迟期无增强均为pCR的独立预测因素(P <0. 05)。多因素Logistic回归分析结果显示MRI增强早期LBSER、MRI增强早期和延迟期MRC大小、MRI延迟期无增强是pCR的独立预测因素(P <0. 05)。LBSER≤1. 6和MRC≤0. 2 cm联合预测pCR特异性最高,为91. 3%。结论:MRI增强早期LBSER是乳腺癌NAC患者pCR的独立预测因素,联合MRI增强早期LBSER和MRC大小可提高预测乳腺癌患者NAC后pCR的诊断效能。更多还原

【Abstract】 Objective: To investigate the predictive value of breast contrast-enhanced MRI with lesion-to-background parenchymal signal enhancement ratio( LBSER) for predicting pathological complete response( pCR) following neoadjuvant chemotherapy( NAC). Methods: One hundred and thirty-six breast cancer patients who had undergone both NAC and contrast-enhanced MRI from January 2008 to December 2016 in our hospital were enrolled.The clinico-pathological features,tumor size measured by MRI,and LBSER on MRI images were recorded. Univariate and multi-univariate logistic regression were used to analyze the predictors of pCR. Receiver operating characteristic curve( ROC) was employed to analyze the diagnostic performance of the relative pCR predictors. Results:The univariate logistic regression results showed that the triple-negative breast cancer,LBSER on early-phase and delay-phase MRI,the MRC size on early-phase and delay-phase MRI,and the delay-phase without enhancement were independently associated with pCR( P < 0. 05). The multi-univariate logistic regression results showed that the LBSER on early-phase MRI,the MRC size on early-phase and delay-phase MRI,and the delay-phase without enhancement were independent predictors of pCR( P < 0. 05). Combination of LBSER≤1. 6 and MRC≤0. 2 cm had the highest specificity of 91. 3% for predicting pCR. Conclusion: LBSER on early-phase MRI is independently associated with pCR. The LBSER combined with MRC can improve the diagnostic performance for predicting pCR in breast cancer patients after NAC.更多还原