Dynamic enhanced MRI evaluation on therapeutic effect of preoperative chemotherapy for breast cancer patients and analysis of related factors: a report of 31 cases

目的 探讨动态增强MRI(dynamic contrast-enhanced MRI)对乳腺癌术前化疗疗效评价的价值,并对近期疗效相关因素进行分析.方法 选择2010年1月至2010年8月本院收治的新发乳腺癌患者中接受术前化疗并已行手术获得组织病理学评价的31例患者为研究对象.术前化疗方案以蒽环类及紫杉类细胞毒药物为基础,对HER-2阳性患者联合应用曲妥珠单克隆抗体,参照实体肿瘤疗效评价标准(RECIST1.1)及组织学分级系统(Miller and Payne grading system)对术前化疗疗效进行综合评价.结果 31例患者中MRI影像学评价完全缓解(CR)5例(16.1%),部分缓解(PR)23例(74.2%),疾病稳定(SD)2例(6.5%),疾病进展(PD)1例(3.2%);组织分级系统评价13例G5(42.0%),5例G4(16.1%),8例G3(25.8%),4例G2(12.9%),1例G1(3.2%).结论 对于符合适应证的乳腺癌患者,个体化选择术前化疗可以使其获益;动态增强MRI对乳腺癌术前化疗疗效的评价与组织病理评价有一定的关系.Objective To investigate dynamic contrast-enhanced MRI evaluation on the therapeutic effect of preoperative chemotherapy in breast cancer patients and to analysis related factors of short-term therapy effect. Methods The study subjects included 31 patients who had received preoperative chemotherapy for primary breast cancer in our department from January 2010 to August 2010. The preoperative chemotherapy regimens were based on anthracyclines and taxanes; and trastuzumab was added for HER-2 positive patients. Response Evaluation Criteria in Solid Tumors (RECIST) and Miller and Payne grading system were used to evaluate the response of preoperative chemotherapy. Results Among the 31 patients, 5(16. l%)patients had complete response (CR), 23(74. 2%) patients had partial response (PR), 2(6. 5%) patients obtained stable disease (SD) and 1(3. 2%) patient obtained progressive disease (PD) according to the MRI evaluation. According to the Miller and Payne grading system, 13(42. 0%) patients had G5,5(16. 1%) patients G4, 8 (25.8%)patients G3, 4 (12. 9%) patients G2, and 1 (3. 2%) patients Gl. Conclusions Individualized preoperative chemotherapy treatment can benefit patients with indications. Dynamic enhanced MRI evaluation on the therapeutic effect of preoperative chemotherapy in breast cancer has certain relation with histopathological evaluation.北京市科技计划项目; 首都医学发展基金项目中国科技核心期刊(ISTIC)03290-2960