Diagnostic performance of magnetic resonance imaging for assessing tumor response in patients with HER2-negative breast cancer receiving neoadjuvant chemotherapy is associated with molecular biomarker profile.
Diagnostic performance of magnetic resonance imaging for assessing tumor response in patients with HER2-negative breast cancer receiving neoadjuvant chemotherapy is associated with molecular biomarker profile.
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DOI：
10.1016/j.clbc.2012.01.009
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发表时间：
2012-04
影响因子：
3.1
通讯作者：
Su MY
中科院分区：
文献类型：
--
作者：
Kuzucan A;Chen JH;Bahri S;Mehta RS;Carpenter PM;Fwu PT;Yu HJ;Hsiang DJ;Lane KT;Butler JA;Feig SA;Su MY
本研究旨在评估激素受体和Ki-67增殖标志物在预测HER2阴性乳腺癌接受新辅助化疗（NAC）时测量残余肿瘤大小的MRI准确性中的影响。54名女性接受了研究。患者接受AC和/或紫杉烷为基础的方案。将MR测定临床完全缓解（CCR）的准确性与病理完全缓解（pCR）进行比较。MRI上可检测到的残余肿瘤的大小与病理诊断的肿瘤大小使用Pearson相关。MRI正确诊断了17例pCR患者中的16例。假阴性8例，激素受体阳性7例，HR阴性1例。MRI的总体敏感性、特异性和准确性分别为78%、94%和83%。阳性预测值为97%，阴性预测值为67%。在mri病理肿瘤大小相关性方面，HR阴性肿瘤的相关性（R=0.79）高于HR阳性肿瘤（R= 0.58）。HR阳性肿瘤的mri病理大小差异大于HR阴性肿瘤（1.6±2.8 cm vs. 0.56±0.9 cm, p=0.05）。Ki-67低增殖（<40%）的肿瘤比Ki-67高增殖（≥40%）的肿瘤尺寸差异更大（1.2±2.0 cm vs. 0.4±0.8 cm p=0.05）。结果表明，MRI对乳腺癌NAC的诊断效能与分子生物标志物谱相关。在HER2阴性肿瘤中，HR阳性肿瘤的MRI准确性低于阴性肿瘤，低增生性肿瘤的MRI准确性低于高增生性肿瘤。这些发现可能有助于手术计划。
This study aimed to evaluate the influence of hormonal receptor and Ki-67 proliferation marker in predicting MRI accuracy of measuring residual tumor size in HER2 negative breast cancer receiving neoadjuvant chemotherapy (NAC). Fifty-four women were studied. Patients received AC and/or taxane-based regimens. The accuracy of MR determined clinical complete response (CCR) was compared to pathological complete response (pCR). The size of detectable residual tumor on MRI was correlated with pathology-diagnosed tumor size using Pearson’s correlation. MRI correctly diagnosed 16 of the 17 pCR patients. There were 8 false negative diagnoses, 7 hormonal receptor (HR) positive and one HR negative. The overall sensitivity, specificity, and accuracy of MRI were 78%, 94%, and 83%, respectively. The positive predictive value was 97% and the negative predictive value was 67%. For MRI-pathology tumor size correlation, HR negative cancers showed a higher correlation (R=0.79) than HR positive cancers (R= 0.58). A worse MRI-pathology size discrepancy was found in HR positive cancer than in HR negative cancer (1.6±2.8 cm vs. 0.56±0.9 cm, p=0.05). Tumors with a low Ki-67 proliferation (<40%) showed a larger size discrepancy than those with a high Ki-67 proliferation (≥40%) (1.2±2.0 cm vs. 0.4±0.8 cm p=0.05). The results showed that the diagnostic performance of MRI for breast cancer undergoing NAC is associated with molecular biomarker profile. Among HER2 negative tumors, the accuracy of MRI was worse in HR positive than negative cancers, and also worse in low proliferative than high proliferative tumors. These findings may help in surgical planning.
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