Effect of shear wave elastography in predicting pathological responses to neoadjuvant chemotherapy in patients with breast cancer
10.3760/cma.j.cn131148-20210224-00123
- VernacularTitle:剪切波弹性成像预测乳腺癌新辅助化疗病理反应性的效能分析
- Author:
Danfeng HUANG
1
;
Lina TANG
;
Youhong SHEN
;
Yaoqin WANG
;
Yijie CHEN
;
Wanping CHEN
;
Wenrong LIN
;
Wenting XIE
Author Information
1. 福建医科大学附属肿瘤医院 福建省肿瘤医院超声科，福州 350014
- Keywords:
Utrasonography;
Shear wave elastography;
Breast cancer;
Neoadjuvant chemotherapy
- From:
Chinese Journal of Ultrasonography
2021;30(8):715-720
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical value of shear wave elastography (SWE) in predicting pathological responses to neoadjuvant chemotherapy in breast cancer.Methods:According to the postoperative pathological responses, 56 patients who received neoadjuvant chemotherapy followed by surgical excision in the Fujian Cancer Hospital from August 2019 to September 2020 were divided into responders and non-responders. The relative change rates of tumor maximum diameter(ΔD2, ΔD4) and SWE stiffness (ΔEmax2, ΔEmax4, ΔEmean2, ΔEmean4) were assessed before NAC and after different NAC cycles (t2, t4). Clinical information, including age, T, N stages, ER, PR, HER2, Ki67, and molecular subtype were also considered as the variables. The independent influencing factors of pathological responses after neoadjuvant chemotherapy were obtained by logistic regression analysis and diagnostic test was carried out.Results:There were 23 cases as responders (41.0%, 23/56), and 33 cases as non-responders (58.9%, 33/56). Results of multivariate analysis showed ΔEmax4 and HER2 index were independent influencing factors of pathological responses ( OR=1.11, P<0.001; OR=31.81, P=0.002). Area under curve of the ΔEmax4 (AUC: 0.869, 95% CI: 0.746-0.941) was higher than that of HER2 (AUC: 0.690, 95% CI: 0.545-0.834). The combination of ΔEmax4 and HER2 gave the best prediction of pathological responses (AUC 0.930, 95% CI: 0.829-0.981). the sensitivity, specificity, diagnostic accuracy, postive predictive value, and negative predictive value were 78.26%, 96.97%, 75.23%, 94.73%, and 86.49%, respectively. Conclusions:ΔEmax4 and HER2 are independent predictors of pathological responses after neoadjuvant chemotherapy for breast cancer. Combined ΔEmax4 and HER2 can improve the predictive diagnostic efficacy of pathological responses to chemotherapy for breast cancer.
