摘要
目的 探讨超声弹性成像(UE)参数联合血清E-钙黏附蛋白(E-cadherin)、孕激素膜受体膜组分1(PGRMC1)评估乳癌新辅助化疗(NAC)疗效的价值.方法 选取2019年3月—2022年3月我院收治的124例行4个周期NAC(每个周期21 d)的乳癌病人,病人化疗前后均行UE检查.依据NAC后的病理检查结果将病人分为缓解组与未缓解组.采用酶联免疫吸附试验法检测血清E-cadherin、PGRMC1水平,通过受试者工作特征曲线下面积(AUC)评估UE、E-cadherin、PGRMC1三者单独及联合检测对乳癌病人NAC疗效的预测价值.结果 NAC后UE结果与病理结果的Kappa系数为0.783(P＜0.05).与缓解组相比,未缓解组NAC后弹性应变率比值(SR)、弹力成像评分(UES)、E-cadherin、PGRMC1 显著增加(t=2.571～14.073,P＜0.05);未缓解组 NAC 后SR、UES、E-cadherin、PGRMC1 降低幅度低于缓解组,差异有统计学意义(t=14.625～50.773,P＜0.05).SR、UES、E-cadherin、PGRMC1 诊断乳癌病人 NAC 后缓解的 AUC 分别为 0.795、0.701、0.764、0.814,E-cadherin 与PGRMC1水平并联再与UE串联后联合诊断的AUC为0.903.结论 UE参数联合血清E-cadherin、PGRMC1对乳癌NAC疗效具有较高的诊断效能.
Abstract
Objective To investigate the value of ultrasound elastography(UE)combined with serum E-cadherin and pro-gesterone receptor membrane component 1(PGRMC1)in evaluating the efficacy of neoadjuvant chemotherapy(NAC)for breast cancer.Methods A total of 124 breast cancer patients who were admitted to our hospital and underwent four cycles of NAC(21 days per cycle)from March 2019 to March 2022 were enrolled,and UE examination was performed before and after chemotherapy.According to the pathological examination results after NAC,the patients were divided into remission group and non-remission group.ELISA was used to measure the serum levels of E-cadherin and PGRMC1,and the area under the ROC curve(AUC)was used to investigate the value of UE,E-cadherin,and PGRMC1 used alone or in combination in predicting the efficacy of NAC in breast cancer patients.Results The Kappa coefficient between UE and pathological results after NAC was 0.783(P＜0.05).Compared with the remission group,the non-remission group had significant increases in elastic strain rate ratio(SR),ultrasound elastography score(UES),E-cadherin,and PGRMC1 after NAC(t=2.571-14.073,P＜0.05),and compared with the remission group,the non-remission group had a significantly lower degree of reductions in SR,UES,E-cadherin,and PGRMC1 after NAC(t=14.625-50.773,P＜0.05).SR,UES,E-cadherin,and PGRMC1 used alone had an AUC of 0.795,0.701,0.764,and 0.814,respectively,in the diagnosis of remission after NAC in breast cancer patients,while E-cadherin and PGRMC1 combined with UE had an AUC of 0.903.Conclusion UE parameters combined with serum E-cadherin and PGRMC1 have a good performance in predicting the efficacy of NAC in breast cancer.
基金项目
河北省医学科学研究课题计划(20221613)
秦皇岛市科学技术研究与发展计划课题(202005A033)
国家科技期刊平台
NSTL
万方数据