Prediction of pathological complete response to neoadjuvant chemotherapy by magnetic resonance imaging in breast cancer patients

Prediction of pathological complete response to neoadjuvant chemotherapy by magnetic resonance imaging in breast cancer patients
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DOI:
10.1016/j.breast.2015.01.001
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发表时间:
2015-04-01
期刊:
影响因子:
3.9
通讯作者:
Noguchi, Shinzaburo
Noguchi, Shinzaburo
中科院分区:
医学2区
文献类型:
--
作者:
Michishita, Shintaro;Kim, Seung Jin;Noguchi, Shinzaburo

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本研究的目的是评估乳腺MRI基线结果是否有助于预测乳腺癌患者对新辅助化疗的病理完全缓解(pCR)。回顾性纳入术前序贯紫杉醇(12个周期)和氟尿嘧啶、表柔比星、环磷酰胺(4个周期)并手术治疗的原发性乳腺癌患者(II-III期),229例患者符合条件。化疗前进行乳房MRI检查。根据MRI形态学将乳腺肿瘤分为圆形+卵圆形和不规则型。圆形+卵圆形肿瘤的pCR率明显高于不规则肿瘤(42.0% vs 17.3%, P < 0.001)。此外,PAM50分析显示,圆形+卵圆形肿瘤中基底瘤和her2富集瘤的发生率明显高于不规则型肿瘤(P = 0.015)。基线MRI形态学似乎是pCR的重要预测因子。圆形+卵圆形肿瘤中基底和her2富集肿瘤的比例较高,这可能解释了它们更好的化疗敏感性。(C) 2015 Elsevier Ltd.版权所有。
The purpose of this study was to evaluate whether the baseline breast MRI findings would be useful for the prediction for pathological complete response (pCR) by breast cancer patients to neoadjuvant chemotherapy. Primary breast cancer patients (stage II-III) preoperatively treated with sequential paclitaxel (12 cycles) and fluorouracil, epirubicin, and cyclophosphamide (4 cycles), followed by surgery were retrospectively enrolled, and 229 patients were eligible. Before chemotherapy, breast MRI studies were performed. Breast tumors were dichotomized into round + oval and irregular types based on MRI morphology. The round + oval tumors showed a significantly higher pCR rate than the irregular tumors (42.0% vs 17.3%; P < 0.001). In addition, PAM50 analysis revealed that basal and HER2-enriched tumors were significantly more prevalent among round + oval than irregular type tumors (P = 0.015). Baseline MRI morphology appears to be a significant predictor for pCR. The higher rate of the basal and HER2-enriched tumors among the round + oval tumors may explain their better chemo-sensitivity. (C) 2015 Elsevier Ltd. All rights reserved.