剪切波弹性成像联合AKT1对判断局部晚期HER2阳性乳腺癌患者新辅助化疗效果及短期预后的预测价值

目的 研究剪切波弹性成像(shear wave elastrography, SWE)联合丝氨酸/苏氨酸蛋白激酶(serine/threonine kinase1,AKT1)对判断局部晚期人类表皮生长因子受体2(human epidermal growth factor receptor-2,HER2)阳性乳腺癌患者新辅助化疗(neoadjuvant chemotherapy, NC)效果及短期预后的预测价值。方法 选取124例局部晚期HER2阳性乳腺癌患者作为研究对象。患者均接受NC治疗，记录病理完全缓解(pathological complete remission, pCR)率。比较不同疗效患者SWE参数和AKT1阳性率，分析影响pCR的相关因素，比较不同病理特征患者短期预后。结果 124例患者中2例失访，122例入组，其中38例达到pCR,pCR率为31.15%。随访时间4～12个月，死亡40例，存活82例，1年生存率67.21%。Logistic多因素分析结果显示，分化程度(OR=0.614,95%CI=0.482～0.782,P<0.001)、弹性模量值(OR=0.4...

Value of shear wave elastrography combined with AKT1 in predicting the efficacy and short-term prognosis of neoadjuvant chemotherapy for HER2-positive locally advanced breast cancer patients

Objective To study the value of shear wave elastrography(SWE) combined with serine/threonine kinase1(AKT1) in predicting the efficacy and short-term prognosis of neoadjuvant chemotherapy(NC) for human epidermal growth factor receptor-2(HER2)-positive locally advanced breast cancer patients.Methods In total, 124 patients with HER2-positive locally advanced breast cancer were selected as research subjects. All patients received NC treatment, and the pathological complete remission(pCR) rate was recorded. The SWE parameters and positive rate of AKT1 of patients with different curative effects were compared, and the related factors affecting the pCR were analyzed. The short-term prognosis of patients with different pathological characteristics was compared.Results Among the 124 patients, 2 were lost to follow-up and 122 were enrolled, including 38 patients who reached the pCR, with the pCR rate of 31.15%. The follow-up time ranged from 4 to 12 months. In addition, 40 cases died and 82 cases survived. The one-year survival rate was 67.21%. Multivariate logistic analysis showed that the degree of differentiation(OR=0.614, 95%CI=0.482-0.782, P＜0.001), elastic modulus(OR=0.431, 95%CI=0.286-0.650, P＜0.001) and AKT1 positive(OR=0.565, 95%CI=0.338-0.944, P=0.029) were independent influencing factors for the curative effect of NC(P＜0.05). The area under ROC curve(AUC) of joint prediction probability of elastic modulus value + AKT1 to evaluate the pCR was higher than that of single index(P＜0.05). The 1-year survival rates of patients with different degree of differentiation, elastic modulus and AKT1 expression level were significantly different(P＜0.05).Conclusion SWE parameters combined with AKT1 can help to judge the NC efficacy and short-term prognosis of HER2-positive locally advanced breast cancer patients.