CAJ | 학술논문

目的：评价彩超对乳腺癌新辅助化疗疗效的价值。方法60例新辅助化疗的乳腺癌患者，运用彩超观察其化疗前后的肿瘤原发灶和腋窝内异常淋巴结的大小，二维超声图的改变以及彩色多普勒血流分布的情况及动力学参数的变化，并且将化疗后术前的超声检查结果与手术后病理结果进行对照。结果超声测量的新辅助化疗后乳腺癌原发灶的各个径线及腋窝淋巴结的径线较化疗前明显缩小，最大流速（Vmax）和阻力指数（RI）也较化疗前明显降低（P ＜00．1）。化疗后术前超声测量的残余癌的最大径和术后病理测量残余癌的最大径具有明显相关性（ r ＝07．94，P ＜00．1）。超声评价乳腺癌病灶变化与病理评价的准确率为70％，敏感度为878．％，特异度为481．％。化疗后术前的超声评估，使5例乳腺癌患者的治疗方案较早的进行更换，及时中止了无效化疗。结论彩超为新辅助化疗提供了简便、准确的疗效观察手段，早期的超声检查有助于临床优化治疗方案。
목적：평개채초대유선암신보조화료료효적개치。방법60례신보조화료적유선암환자，운용채초관찰기화료전후적종류원발조화액와내이상림파결적대소，이유초성도적개변이급채색다보륵혈류분포적정황급동역학삼수적변화，병차장화료후술전적초성검사결과여수술후병리결과진행대조。결과초성측량적신보조화료후유선암원발조적각개경선급액와림파결적경선교화료전명현축소，최대류속（Vmax）화조력지수（RI）야교화료전명현강저（P ＜00．1）。화료후술전초성측량적잔여암적최대경화술후병리측량잔여암적최대경구유명현상관성（ r ＝07．94，P ＜00．1）。초성평개유선암병조변화여병리평개적준학솔위70％，민감도위878．％，특이도위481．％。화료후술전적초성평고，사5례유선암환자적치료방안교조적진행경환，급시중지료무효화료。결론채초위신보조화료제공료간편、준학적료효관찰수단，조기적초성검사유조우림상우화치료방안。
Objective To explore the value of color doppler ultrasound (US)in estimating the effects of neo-adjuvant chemotherapy for breast carcinoma (NAC) .Methods Pre-and-post the neoadjuvant chemothera-py ,60 patients were examined by color doppler ultrasound to compare the changes of the primary tumors and the axillary lymph nodes (Including size ,two-dimensional ultrasound images ,the blood flow distribu-tion ,and other hemodynamic parameters);all US results were compared with those of the post-operative pathological examination .Results After NAC ,the size of primary breast cancer and the axillary lymph nodes measured by US decreased apparently (P <0 0.1) ,and the Vmax and RI of primary breast cancer decreased too when compared with those before chemotherapy .There was an obvious relativity between the biggest diameter of residual tumor measured by US before the operation and that measured by patholo-gy (r =0 7.94 , P <0 0.1) .Compared with pathologic findings ,US had the coincidence rate of 70% ,re-sponse rate of 87 .8% ,specificity of 48 .1% after chemotherapy .The color-doppler-ultrasound estimation before the operation made five patients change the regimen early and stop ineffectual chemotherapy in time . Conclusion Color doppler ultrasound could assess the value of NAC conveniently and accurately and the early monitoring by US helps optimize the therapy .