ABVS观察乳腺癌新辅助化疗肿瘤体积变化与HER2表达的相关性
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摘要
目的通过乳腺自动全容积扫查系统(ABVS)在乳腺癌新辅助化疗(NACT)期间观察肿瘤体积变化,探讨其与乳腺癌原癌基因人类表皮生长因子受体2基因(HER2)表达的相关性。方法使用ABVS分析109例乳腺癌患者NACT期间各个化疗周期后肿瘤体积的变化,追踪病理及免疫组化结果,采用t检验进行单因素分析,再进行Logistic回归分析筛选独立的预测指标,并建立回归方程;使用受试者工作特征(ROC)曲线评价回归方程预测HER2表达情况的价值。结果与HER2表达有显著相关性的参数包含:NACT第二周期后肿瘤体积(V2)、NACT第三周期后肿瘤体积(V3)及术前肿瘤体积(V4)(P均<0.05),但进入Logistic回归方程的变量为V2及V4;由回归方程产生的预测概率PnewROC曲线下面积为0.875,预测价值良好。结论 ABVS观察肿瘤体积变化对评估乳腺癌患者HER2表达有良好的预测价值。
Objective To investigate the relationship between the volume change of breast carcinoma by Automatic Breast Volume Scanning of neoadjuvant chemotherapy(NACT)and Human epidermalgrowth factor receptor-2(HER2)expression.Methods The volume changes in NACT and pathological characteristics of 109 patients with breast carcinoma were collected,and were firstly tested with t test,secondly,analyzed by Logistic regression,then,established a regression equation.Finally,the Receiver operating characteristic(ROC)cure was used to assess the accuracy of the regression equation.Results Analysis showed that the expression of HER2 was significantly associated with those parameters,such as,at the end of the second cycle of NACT(V2),the third(V3)and the final cycle(V4),whereas,V2 and V4 entered into the Logistic regression equation.And,area under the ROC curve of pre-probability p(pnew)generated by the regression equation was 0.875.Conclusions The volume changes have better predictive value for HER2 expression in patients with breast carcinoma.
Objective To investigate the relationship between the volume change of breast carcinoma by Automatic Breast Volume Scanning of neoadjuvant chemotherapy(NACT)and Human epidermalgrowth factor receptor-2(HER2)expression.Methods The volume changes in NACT and pathological characteristics of 109 patients with breast carcinoma were collected,and were firstly tested with t test,secondly,analyzed by Logistic regression,then,established a regression equation.Finally,the Receiver operating characteristic(ROC)cure was used to assess the accuracy of the regression equation.Results Analysis showed that the expression of HER2 was significantly associated with those parameters,such as,at the end of the second cycle of NACT(V2),the third(V3)and the final cycle(V4),whereas,V2 and V4 entered into the Logistic regression equation.And,area under the ROC curve of pre-probability p(pnew)generated by the regression equation was 0.875.Conclusions The volume changes have better predictive value for HER2 expression in patients with breast carcinoma.
引文
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[11]BLACKWELL K L,DEWHIRST M W,LIOTCHEVA V,et al.HER-2gene amplification correlates with higher levels of angiogenesis and lower levels of hypoxia in primary breast tumors[J].Clin Cancer Res,2004,10(6):4083-4088.
[12]WILLIAM W,LI P.Tumor angiogenesis molecular pathology therapeutic targeting,and imaging[J].Acad Radiol,2000,7(10):800-811.
[13]BANDO H.Vascular endothelial growth factor and bevacitumab in breast cancer[J].Breast Cancer,2007,14(2):163-173.
[14]周南,张海,陈立新,等.三维超声VOCAL参数与乳腺癌HER2表达的相关性[J].中国超声医学杂志,2014,30(6):493-499.
[15]FRéDéRIQUE,PENAULT-LLORCA.Breast cancer classification is evolving[J].Biologie aujourd′hui,2014,208(4):251-259.
[2]万静,吴蓉,姚明华,等.乳腺癌免疫组化亚型的超声、临床和病理分析[J].影像诊断与介入放射学,2016,25(3);210-214.
[3]STRAVER M E,ADRICHEM J C,RUTGERS E J,et al.Neoadjuvant systemic therapy in patients with operable primary breast cancer:more benefits than breast-conserving therapy[J].Ned Tijdschr Geneeskd,2008,152(46):2519-2525.
[4]GAMPENRIEDER S P,RINNERTHALER G,GREIL R.Neoadjuvant chemotherapy and targeted therapy in breast cancer:Past,present,and future[J/OL].J Oncol,2013,2013(22):732047.
[5]CADOO K A,FORNIER M N,MORRIS P G.Biological subtypes of breast cancer:Current concepts and implications for recurrence patterns[J].Q J Nucl Med Mol Imaging,2013,57(4):312-321.
[6]SUBBIAH I M,GONZALEZ-ANGULO A M.Advances and Future Directions in the Targeting of HER2-positive Breast Cancer:Implications for the Future[J].Curr Treat Options Oncol,2013,12(10):56.
[7]倪新初,孙苏平.乳腺癌的分子亚型及治疗策略研究进展[J].癌症进展,2009,7(4):422-426.
[8]周军华,孟洁,韩若凌,等.基于常规超声发现的乳腺病灶与自动乳腺全容积扫查一致性分析[J].中国超声医学杂志,2016,32(10):877-879.
[9]BLACKWELL K L,DEWHIRST M W,LIOTCHEVA V,et al.HER-2gene amplification correlates with higher levels of angiogenesis and lower levels of hypoxia in primary breast tumors[J].Clin Cancer Res,2004,10(6):4083-4088.
[10]BIANCHINI G,BALKO J M,MAYER I A,et al.Triple-negative breast cancer:challenges and opportuuities of a heterogeneous disease[J].Nat Rev Clin Oncol,2016:13(5):674-690.
[11]BLACKWELL K L,DEWHIRST M W,LIOTCHEVA V,et al.HER-2gene amplification correlates with higher levels of angiogenesis and lower levels of hypoxia in primary breast tumors[J].Clin Cancer Res,2004,10(6):4083-4088.
[12]WILLIAM W,LI P.Tumor angiogenesis molecular pathology therapeutic targeting,and imaging[J].Acad Radiol,2000,7(10):800-811.
[13]BANDO H.Vascular endothelial growth factor and bevacitumab in breast cancer[J].Breast Cancer,2007,14(2):163-173.
[14]周南,张海,陈立新,等.三维超声VOCAL参数与乳腺癌HER2表达的相关性[J].中国超声医学杂志,2014,30(6):493-499.
[15]FRéDéRIQUE,PENAULT-LLORCA.Breast cancer classification is evolving[J].Biologie aujourd′hui,2014,208(4):251-259.