DONG Jingmin, XU Kun, BIAN Jia, WANG Hongxia, REN Wen, SU Wenjing, QU Zhengwei, ZHONG Xiaofei
滨州医学院学报. 2018, 41(4): 284-288.
Objective To evaluate the effect of neoadjuvant chemotherapy (NAC) with 3.0 T dynamic enhanced magnetic resonance imaging (DCE-MRI) in breast invasive ductal carcinoma and analyze whether the change of biological factors can predict the effect of NAC.Methods Thirty-three patients of breast invasive ductal carcinoma underwent DCE-MRI examination before and after NAC;lesions were performed pathological examination before and after NAC.Lesion morphology,margin,lumpy or not,enhanced features and largest diameter reduction rate were analyzed before and after NAC.After NAC,according to the response evaluation criteria of solid tumors (RECIST),the patients were divided into effective and invalid groups,and the difference of the maximum diameter reduction rate of the two groups was tested by independent sample t test.The changes of expression levels of estrogen receptor (ER),progesterone receptor (PR), human epidermal growth factor receptor 2 (Her-2) and cell value-added nuclear antigen (Ki67) before and after NAC were analyzed.Results There was no significant difference in the shape and intensifying characteristics of breast cancer before and after NAC (P>0.05).There was a statistically significant difference in TIC type before and after NAC (P<0.05).In 33 patients, effective group of 23 cases,10 cases of invalid group.The largest diameter reduction rate of effective group was (61.31+20.13) %,invalid group was (17.06+10.21) %,the largest diameter reduction rate of the two group was compared,there was significant difference (P=0.000).Compared the expression levels of ER,PR,Her-2, Ki67 before and after NAC, there were no significant differences in ER,PR,Her-2 (P>0.05),there were statistically significant differences in the changes of Ki67 (P=0.028).Conclusion 3.0T DCE-MRI can monitor the size,shape and enhancement characteristics of breast cancer during NAC.It can be used for preoperative evaluation of residual lesions after NAC,and combined with changes in biological factors,to predict the effect of NAC.