DCE-MRI定量参数联合血清ANXA2、FGFR4对乳腺癌新辅助化疗无效的预测价值OA

Objective To investigate the predictive value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)quantitative parameters combined with serum annexin A2(ANXA2)and fibroblast growth factor receptor 4(FGFR4)for nonresponse to neoadjuvant chemotherapy(NAC)in breast cancer pa-tients.Methods A total of 219 patients with breast cancer treated at the hospital from January 2022 to March 2025 were enrolled.All patients received NAC and subsequent surgery.DCE-MRI examinations were per-formed before the initiation of NAC and after the completion of two cycles,and serum ANXA2 and FGFR4 levels were measured by enzyme-linked immunosorbent assay.Treatment response was evaluated based on postoperative Miller-Payne pathological response grading,and the patients were divided into a response group(grades Ⅳ-Ⅴ)and a nonresponse group(grades Ⅰ-Ⅲ).Pearson correlation analysis was used to assess the correlations between serum ANXA2 and FGFR4 levels and quantitative DCE-MRI parameters in patients with breast cancer.Multivariate Logistic regression analysis was performed to identify predictors of nonresponse to NAC in breast cancer patients.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of DCE-MRI quantitative parameters and serum ANXA2 and FGFR4 alone and in combi-nation for nonresponse to NAC.The combined prediction model was internally validated using the bootstrap method.Results There were 157 patients in the response group and 62 in the nonresponse group.Before chemotherapy,extravascular extracellular volume fraction(Ve),volume transfer constant(Ktrans),rate con-stant(Kep),and serum ANXA2 and FGFR4 levels were not significantly different between the two groups(P>0.05).After two cycles of chemotherapy,Ve,Ktrans,Kep and serum ANXA2 and FGFR4 levels were higher in the nonresponse group than those in the response group(P<0.05).Serum ANXA2 and FGFR4 lev-els were positively correlated with Ve,Ktrans and Kep in patients with breast cancer(P<0.05).Elevated Ve,Ktrans,Kep and serum ANXA2 and FGFR4 levels were identified as predictors of nonresponse to NAC in breast cancer patients(P<0.05).The area under the curve(AUC)of the combined prediction of nonresponse to NAC in breast cancer patients including Ve,Ktrans,Kep,serum ANXA2 and FGFR4 was 0.944,which was sig-nificantly higher than the AUC of each parameter alone(Zcombination vs.Ve=3.341,Zcombination vs.Ktrans=2.695,Zcombination vs.Kep=3.619,Zcombination vs.ANXA2=3.401,Zcombination vs.FGFR4=2.998;all P<0.05).Bootstrap internal vali-dation showed good agreement between the predicted and observed probabilities of nonresponse to NAC for the model combining quantitative DCE-MRI parameters with serum ANXA2 and FGFR4 levels.Conclusion DCE-MRI quantitative parameters combined with serum ANXA2 and FGFR4 provide effective early prediction of nonresponse to NAC in patients with breast cancer,with good predictive value.