三维及彩色多普勒超声评估乳腺癌新辅助化疗疗效的价值

目的 探讨三维超声及彩色多普勒超声在乳腺癌新辅助化疗（NAC）疗效评估中的应用价值。方法 收集中南大学湘雅医院经病理学证实并行NAC 的乳腺癌患者80 例，化疗前后均行临床评估（触诊）、二维及三维超声检查，根据化疗前后乳腺肿块变化与病理评估结果进行比较。结果 触诊与病理学评估有效率比较，差异有统计学意义（P <0.05）。二维、三维超声评估与病理学评估有效率比较，差异无统计学意义（P >0.05）。NAC 后残存肿瘤二维、三维超声测量体积与病理学测量体积均呈正相关（P <0.05）。有效组NAC 前后病灶内血流分级变化数、血流阻力指数比较，差异有统计学意义（P <0.05）。结论 三维超声评估NAC 疗效与病理学评估具有较高的一致性，良好的临床价值可作为乳腺癌NAC 疗效评估的有效方法，乳腺癌病灶超声血流信号的变化有助于乳腺癌NAC 疗效判断。

Study of three-dimensional and color Doppler ultrasonography inevaluating effect of neoadjuvant chemotherapy for breast cancer

Objective To investigate the clinical application value of three-dimensional ultrasonographyand color Doppler ultrasonography in the evaluation of neoadjuvant chemotherapy for breast cancer. Methods Inthis study 80 breast cancer patients confirmed by pathology who received neoadjuvant chemotherapy in XiangyaHospital of Central South University were collected. Before and after neoadjuvant chemotherapy, all the patientsunderwent clinical assessment, two-dimensional (2D) ultrasonographic and three-dimensional (3D) ultrasonographicexaminations. The results were compared with the pathological evaluation results according to the changes ofbreast masses. Results There was a significant difference between clinical assessment and pathological assessment(P < 0.05). However, the 2D ultrasonographic and 3D ultrasonographic assessments were not significantly differentfrom the pathological assessment (P > 0.05). The maximum diameters of the residual tumors after neoadjuvantchemotherapy by 2D and 3D ultrasound measurement were positively correlated with those by pathologicalevaluation (P < 0.05). In the effective group, the differences in the dropping grade of blood flow grading and reductionof blood flow resistance index before and after chemotherapy had statistical significance (P < 0.05). Conclusions 3Dultrasonographic assessment has high consistency with pathological evaluation for curative effect of neoadjuvantchemotherapy. The change of ultrasound blood flow signal in breast cancer masses can be helpful to determine thecurative effect of neoadjuvant chemotherapy.