Early Prediction of Neoadjuvant Chemotherapy Efficacy in Breast Cancer by Dynamic Contrast-Enhanced Magnetic Resonance Imaging Combined with Clinicopathological Features
Early Prediction of Neoadjuvant Chemotherapy Efficacy in Breast Cancer by Dynamic Contrast-Enhanced Magnetic Resonance Imaging Combined with Clinicopathological Features
Objective To identify effectiveness-related indicators by dynamic contrast-enhanced magnetic resonance ima-ging(DCE-MRI)combined with clinicopathological features and evaluate the optimal threshold for tumor reduction rate(TRR)and early phase enhancement rate(EER)reduction after two cycles of neoadjuvant chemotherapy(NAC),and a comprehensive model was established to predict pathological complete response(pCR)after NAC at an early stage.Methods Patients with invasive breast cancer who underwent NAC at the Affiliated Hospital of Southwest Medical University from February 2021 to December 2022 were retrospectively collected.According to the efficacy,it is divided into pCR group and Non-pCR group,the clinicopathological features of the two groups were compared,multivariate Logistic regression analysis was used to determine the independent predic-tors of pCR,and a nomogram model for predicting pathological responses was established based on these indicators.Results A total of 267 patients were collected,including 107 pCR and 160 Non-pCR.The optimal threshold for TRR was 50.8%and for EER reduction was 66.7%.Multivariate analysis showed that clinical T stage,molecular subtype,TRR,and EER differences were independent influencing factors of pCR(all P＜0.05),and the area under the receiver operating characteristic curve(AUC)of the subjects in the nomogram model established based on these factors was 0.926,the sensitivity was 96.3%,and the specifici-ty was 80.0%.After Bootstrap's internal verification,the AUC value is 0.905,and the calibration curve also shows that the pre-dicted probability matches the actual probability well,indicating that the model has better predictive ability.Conclusion The op-timal TRR is 50.8%and the EER difference is 66.7%after two cycles of NAC.Clinical T stage,molecular subtype,TRR,and EER difference are independent influencing factors of pCR,and the prediction model of breast cancer efficacy established by this method has good predictive ability.
关键词
乳腺癌/新辅助化疗/动态增强磁共振成像/病理完全缓解/列线图模型
Key words
breast cancer/neoadjuvant chemotherapy/dynamic contrast-enhanced magnetic resonance imaging/patho-logical complete response/nomogram model
维普
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