Q—box手动描绘模式剪切波弹性成像对乳腺癌新辅助化疗后腋窝淋巴结转移的早期预测(1)
【摘要】 目的：探討Q-box手动描绘模式剪切波弹性成像(shear-wave elastography，SWE)评估乳腺癌硬度对新辅助化疗(neoadjuvant chemotherapy，NAC)后腋窝淋巴结转移的预测价值。方法：纳入符合条件的乳腺癌患者143例，使用SWE评估NAC前乳腺肿物的平均硬度和最大硬度，6周期NAC后，病理评估患者乳腺癌腋窝淋巴结转移情况，并将其作为诊断金标准，进一步采用Logistic回归分析得出影响腋窝淋巴结转移的独立危险因素，并评估SWE参数对预测NAC后乳腺癌腋窝淋巴结转移的诊断效能。结果：多元回归分析结果显示，肿物浸润直径、平均硬度及最大硬度均是预测腋窝淋巴结转移的独立影响因素(字2=17.4、28.5、25.6，OR=1.79、2.69、2.75，P<0.05)。诊断试验证实SWE评估的最大硬度预测NAC后乳腺癌腋窝淋巴结转移的诊断效能最高(AUC=0.88)，Z检验提示无论是最大硬度还是平均硬度与浸润直径的AUC比较，差异均有统计学意义(P<0.05)。结论：Q-box手动描记模式SWE评估的乳腺癌硬度预测NAC后腋窝淋巴结转移的效能较好，其可为NAC后乳腺癌腋窝淋巴结转移情况提供重要参考依据。
, 百拇医药
【关键词】 剪切波弹性成像； 新辅助化疗； 乳腺癌； 腋窝淋巴结转移
Manual Tracing Q-box of Shear-wave Elastography for the Prediction of Breast Cancer Axillary Lymph Node Metastasis after Neoadjuvant Chemotherapy/MA Yufeng，ZHANG Xin，ZHANG Wei，et al.//Medical Innovation of China，2018，15(26)：-133
【Abstract】 Objective：To determine the prediction of manual tracing Q-box of shear-wave elastography(SWE) for axillary lymph node metastasis after neoadjuvant chemotherapy(NAC).Method：143 eligible patients with breast cancer were consecutively included.The mean and maximum stiffness of breast cancer were evaluated befeore NAC by SWE.After six cycles of NAC，the axillary lymph node metastasis was recorded and considered as the golden standard which would be confirmed by postoperative pathology.Multivariate logistic regression was used to test independent risk factors for axillary lymph node metastasis and predictive diagnostic tests were also performed.Result：The results of multiple regression analysis showed that the diameter，average hardness and maximum hardness of tumor infiltration were independent factors to predict axillary lymph node metastasis(字2=17.4，28.5，25.6，OR=1.79，2.69，2.75，P<0.05).The maximum stiffness showed the best overall diagnostic performance regarding predicting axillary lymph node metastasis after NAC(AUC=0.88).The Z test indicated that both the maximum hardness and the average hardness were compared with the AUC of infiltration diameter，the differences were statistically significant(P<0.05).Conclusion：The performance of stiffness evaluating by manual tracing Q-box of SWE for prediction of axillary lymph node metastasis after NAC is favorable，which is important reference for the metastasis of axillary lymph nodes after NAC.
【Key words】 Shear-wave elastography； Neoadjuvant chemotherapy； Breast cancer； Axillary lymph node metastasis
First-author’s address：General Hospital of Fuxin Mining Industry Group，Fuxin 123000，China, 百拇医药(马玉峰 张昕 张微 尹中波)
, 百拇医药
【关键词】 剪切波弹性成像； 新辅助化疗； 乳腺癌； 腋窝淋巴结转移
Manual Tracing Q-box of Shear-wave Elastography for the Prediction of Breast Cancer Axillary Lymph Node Metastasis after Neoadjuvant Chemotherapy/MA Yufeng，ZHANG Xin，ZHANG Wei，et al.//Medical Innovation of China，2018，15(26)：-133
【Abstract】 Objective：To determine the prediction of manual tracing Q-box of shear-wave elastography(SWE) for axillary lymph node metastasis after neoadjuvant chemotherapy(NAC).Method：143 eligible patients with breast cancer were consecutively included.The mean and maximum stiffness of breast cancer were evaluated befeore NAC by SWE.After six cycles of NAC，the axillary lymph node metastasis was recorded and considered as the golden standard which would be confirmed by postoperative pathology.Multivariate logistic regression was used to test independent risk factors for axillary lymph node metastasis and predictive diagnostic tests were also performed.Result：The results of multiple regression analysis showed that the diameter，average hardness and maximum hardness of tumor infiltration were independent factors to predict axillary lymph node metastasis(字2=17.4，28.5，25.6，OR=1.79，2.69，2.75，P<0.05).The maximum stiffness showed the best overall diagnostic performance regarding predicting axillary lymph node metastasis after NAC(AUC=0.88).The Z test indicated that both the maximum hardness and the average hardness were compared with the AUC of infiltration diameter，the differences were statistically significant(P<0.05).Conclusion：The performance of stiffness evaluating by manual tracing Q-box of SWE for prediction of axillary lymph node metastasis after NAC is favorable，which is important reference for the metastasis of axillary lymph nodes after NAC.
【Key words】 Shear-wave elastography； Neoadjuvant chemotherapy； Breast cancer； Axillary lymph node metastasis
First-author’s address：General Hospital of Fuxin Mining Industry Group，Fuxin 123000，China, 百拇医药(马玉峰 张昕 张微 尹中波)
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