多模态磁共振成像在不同分子亚型乳腺癌新辅助化疗早期疗效评估的价值研究OA

Objective:To analyze values of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and diffusion-weighted imaging(DWI)in assessing early curative effect of neoadjuvant chemotherapy(NAC)for different molecular subtypes of breast cancer.Methods:A total of 90 patients with locally advanced breast cancer and NAC who underwent pathological diagnosis and were confirmed at Wujin Hospital of Traditional Chinese Medicine of Changzhou during January 2019 and October 2024 were retrospectively analyzed,which included 26 cases of Luminal A type,41 cases of Luminal B type,and 23 cases of overexpression type of Human epidermal growth factor(HER-2)in molecular subtypes of breast cancer.The maximum diameter(D),early enhancement rate(EER),maximum enhancement rate(MER),apparent diffusion coefficient(ADC)value,and relative ADC(rADC)value of the lesion were measured and recorded.The change rates of them(∆D%,∆EER%,∆MER%,∆ADC%,∆rADC%)between before and after NAC treatment were calculated respectively.The degrees of clinical reactions(Clinically significant reaction and non-clinically significant reaction about NAC)of NAC in different molecular subtypes of breast cancer were compared.The differences of D0,D2,∆ D,EER0,EER2,∆EER,MER0,MER2,∆MER,ADC0,ADC2,∆ADC,rADC0,rADC2,and ∆rADC among different molecular subtypes of breast cancer were compared and analyzed.The receiver operating characteristic(ROC)curve was drawn,and the area under curve(AUC)of the ROC curve was calculated,then,the diagnostic efficacies of DCE-MRI and DWI indicators were analyzed.Results:Among 90 patients with breast cancer who underwent NAC,36 cases occurred significantly clinical reaction and 54 cases occurred non-significantly clinical reaction.Multivariate analysis showed that EER0,∆EER,and ∆MER were influencing factors to NAC in treating Lumina A-type breast cancer(OR=1.370,1.607,1.182,P<0.05).The ∆D,EER0,∆EER,∆MER,ADC2,and rADC0 were the influencing factors to NAC in treating Lumina B-type breast cancer(OR=2.098,1.415,1.562,1.182,1.624,1.592,P<0.01).The ∆D,∆EER,∆MER,∆ADC,and ADC2 were the influencing factors to NAC in treating HER-2 overexpression-type breast cancer(OR=1.705,1.522,2.142,2.185,1.537,1.592,P<0.05).Conclusion:Multi-modal magnetic resonance can be used as an effective mean to assess the curative effect of NAC,and the diagnostic efficacies of different parameters of that for different subtypes are different.