Objective To explore the predictive value of response to neoadjuvant chemotherapy(NAC)in local advanced breast cancer with contrast-enhanced ultrasound(CEUS)of axillary lymph node.Methods CEUS of metastatic axillary lymph nodes in 58 patients stacng Ⅱ-Ⅲ breast cancer was performed before and after NAC treatment. The enhancement patterns and parameters of time-intensity curve were assessed and compared with the pathology.Results The clinic response evaluation were drug-effective in 35 cases and no change in 23 ones.There Were no significant differences in enhancement patterns between no-change and drugeffective groups.Lymph node cortex arriving time was longer in drug-effective cases than that in no-change ones after NAC,whereas it showed no significant differences before NAC.Statistical significant difierence in enhancement duration(ED)was found between the two groups before NAC,which decreased markedly in drug-effective case8 after NAC.Histopatholngic response could be predicted with a sensitivity of 77% and a specificity of 90% by standardized ED below 275 seconds after NAC.No significant difference was found in time to peak(TP),peak intensity(PI)between the two groups.Conclusion The perfusion pattern of axillary lymph node CEUS after NAC Was insufficient to predict curative effect.But the lymph node cortex arriving time and enhancement duration may be of value in the prediction of clinical response to chemotherapy.

Immunohistochemistry was carried out for assessment of the expression of IgG4 and IgG in 29 patients with Hashimoto's thyroiditis (HT) and 26 other patients with subacute thyroiditis,thyroid adenoma,and thyroid carcinoma.HT group were divided into IgG4 HT (10/29) and non-IgG4 HT (19/29) groups.Statistical analyses of clinical and histological characteristics were also conducted in both groups.2 cases of subacute thyroiditis were IgG4 positive (2/26).The IgG4 positive plasma cells,IgG positive plasma cells,and ratio of IgG4 +/IgG + plasma cells in IgG4 HT cases were significantly higher than non-IgG4 HT ones(P＜0.05).The serum Fl4 in IgG4 HT cases were lower than non-IgG4 HT ones(P＜0.05).After operation,IgG4 HT had a greater proportion for accepting thyroxin treatment(P＜0.05).IgG4 HT is a new-found disease which has particular histological and immunological features and would have good response for cortical hormone therapy.Serum and tissue examination of IgG4 seems to be helpful to the diagnosis of IgG4 HT.