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目的分析三阴性乳腺癌新辅助化疗(NAC)前后的声像图变化,探讨高频超声对NAC疗效的评估价值。方法回顾性分析53例三阴性乳腺癌患者NAC前后病灶的大小、血流和硬度改变,并与病理对照评估。结果 NAC后超声检查9例病灶消失,其灵敏度、特异度、准确率分别为87.5%、65%、81.1%;以残余灶的最大径线、血流等级、弹性评分变化作为NAC后的评效指标,评估化疗有效的准确率分别为79.2%、84.9%、94.3%。灵敏度分别为95.2%、95.6%、97.9%。阳性预测值为95.2%、95.6%、97.9%。一致性检验Kappa值分别为0.53、0.75、0.81。结论超声对三阴性乳腺癌NAC疗效有重要评估价值,NAC后以超声弹性评分、血流等级为评效指标评估残余灶的诊断符合率、灵敏度高于以最大径线为评效指标评估残余灶,与病理组织学评估化疗的有效性具有较高的一致性。
Objective To analyze the changes of sonography before and after neoadjuvant chemotherapy (NAC) in triple-negative breast cancer so as to evaluate the value of high-frequency ultrasound in evaluating the efficacy of NAC. Methods The size, blood flow and hardness of 53 patients with triple negative breast cancer before and after NAC were retrospectively analyzed and compared with the pathology. Results After NAC, the lesions of 9 cases disappeared, the sensitivity, specificity and accuracy were 87.5%, 65% and 81.1% respectively. The changes of the maximum diameter, blood flow grade and elastic score of residual lesions were evaluated after NAC Indicators, the effective rate of assessment of chemotherapy were 79.2%, 84.9%, 94.3% respectively. Sensitivity were 95.2%, 95.6%, 97.9%. The positive predictive value was 95.2%, 95.6%, 97.9%. The consistency test Kappa values were 0.53,0.75,0.81. Conclusion Ultrasound has an important value in evaluating the efficacy of NAC in triple-negative breast cancer. After NAC, the diagnostic accuracy of the residual lesions is evaluated by using the ultrasonic elasticity score and the blood flow grade as the evaluation index, and the sensitivity is higher than that of the residual line with the largest diameter as the evaluation index , And histopathological evaluation of the effectiveness of chemotherapy has a higher consistency.