CAJ | 학술논문

目的探讨连续超声引导下Mammotone穿刺活检在乳腺癌新辅助化疗疗效判定中的临床意义.方法选取24例Ⅱ或Ⅲ期接受TEC方案新辅助化疗的乳腺癌患者,分别在新辅助化疗前和2个疗程后接受超声引导下Mammotone穿刺活检,进行前后对比的病理学评价,同时结合超声评价进行综合分析.结果 2个疗程后,超声评价:18例肿瘤体积明显减少(完全缓解3例和部分缓解15例),6例肿瘤体积减少不明显或增大(无变化3例和进展3例)；病理学评价:Miller-Payne分级5级2例,4级18例,3级1例,2级2例,1级1例.超声评价6例肿瘤体积减少不明显或增大患者中,2例病理学评价时见肿瘤细胞明显减少,瘤床纤维组织增生(Miller-Payne分级为4级).超声对乳腺癌新辅助化疗疗效评价有效率为75.0％(18/24),而病理学评价有效率为83.3％(20/24),两者比较差异无统计学意义(P＞0.05),具有较好的一致性(Kappa=0.750).结论超声可以对多数乳腺癌新辅助化疗的疗效进行评价；病理学评价是乳腺癌新辅助化疗疗效评价的“金标准”；连续超声引导下Mammotone穿刺活检技术对超声评价疗效欠佳者,可能更有实际临床研究意义.
목적 탐토련속초성인도하Mammotone천자활검재유선암신보조화료료효판정중적림상의의.방법 선취24례Ⅱ혹Ⅲ기접수TEC방안신보조화료적유선암환자,분별재신보조화료전화2개료정후접수초성인도하Mammotone천자활검,진행전후대비적병이학평개,동시결합초성평개진행종합분석.결과 2개료정후,초성평개:18례종류체적명현감소(완전완해3례화부분완해15례),6례종류체적감소불명현혹증대(무변화3례화진전3례)；병이학평개:Miller-Payne분급5급2례,4급18례,3급1례,2급2례,1급1례.초성평개6례종류체적감소불명현혹증대환자중,2례병이학평개시견종류세포명현감소,류상섬유조직증생(Miller-Payne분급위4급).초성대유선암신보조화료료효평개유효솔위75.0％(18/24),이병이학평개유효솔위83.3％(20/24),량자비교차이무통계학의의(P＞0.05),구유교호적일치성(Kappa=0.750).결론 초성가이대다수유선암신보조화료적료효진행평개；병이학평개시유선암신보조화료료효평개적“금표준”；련속초성인도하Mammotone천자활검기술대초성평개료효흠가자,가능경유실제림상연구의의.
Objective To investigate the curative effect evaluation of continuous ultrasound-guided Mammotone biopsy technique on the neoadjuvant chemotherapy (NCT) of breast cancer.Methods Twenty-four cases with Ⅱ or Ⅲ period breast cancer who accepted TEC project NCT were selected.The patients accepted continuous ultrasound-guided Mammotone biopsy respectively before NCT and after completion of two cycles of NCT,the pathology evaluation was contrasted in combination with the ultrasonic evaluation analysis.Results After two cycles of NCT,ultrasonic evaluation:18 cases' tumor volume were significantly reduced (complete remission in 3 cases and partial remission in 15 cases),6 cases' tumor volume were not obviously reduced or increased (stable disease in 3 cases and progressive disease in 3 cases).Pathological evaluation:Miller-Payne grade 5 grade in 2 cases,4 grade in 18 cases,3 grade in 1 case,2 grade in 2 cases,1 grade in 1 case.Six cases' tumor volume were not obviously reduced or increased by ultrasonic evaluation,2 cases' tumor cells of pathological evaluation were significantly reduced,and tumor bed fibrous tissue hyperplasia (Miller-Payne grade 4 grade).Ultrasound on breast cancer NCT of the efficiency evaluation was 75.0％ (18/24),while the pathological evaluation efficiency was 83.3％ (20/24),there was no statistical difference (P ＞ 0.05),had a good consistency (Kappa =0.750).Conclusions Ultrasound can be used for the evaluation of the majority of breast cancer response to the NCT,while the pathological evaluation is the "gold standard" which to assess the efficacy of the NCT in breast cancer.The continuous ultrasound-guided Mammotone biopsy technique may be more practical significance of the clinical application for the case that is poor curative effect evaluation with the ultrasonic imaging.