Evaluation Of The Efficacy Of Neoadjuvant Chemotherapy In Breast Cancer Using Strain Rate Ratio Method Of Ultrasound Elastography

ObjectiveThis study discussed the application value of strain rate ratio method of ultrasound elastography in evaluating the efficacy of neoadjuvant chemotherapy for breast cancer,in order to evaluate whether it could be one of the indicators for evaluating the efficacy of neoadjuvant chemotherapy for breast cancer.MethodsFrom May 2016 to December 2017,101 women with breast tumors(106 lesions)from Second Affiliated Hospital of Jilin University were recruited.Among them,59 patients(64 lesions)werediagnosed as benign breast tumors and 42(42 lesions)were malignant breast tumors.The patients were diagnosed by both strain rate ratio of ultrasound elastography and two-dimensional ultrasound.The ROC curves of these two methods were drew and the area under curve(AUC)were calculated with MedCalc software.The specificity and sensitivity of the two diagnosed methods were compared.Thebest strain rate ratio ofultrasonic elasticityfor diagnosis of benign and malignant breast tumors were analyzedby ROC curve with SPSS 19.0.The changes of thestrain rate ratio ofultrasonic elasticity before and after neoadjuvant chemotherapy for breast cancer(various chemotherapy cycles)and the changing trend among each chemotherapy cycles were also compared.At last,the consistency between thestrain rate ratio ofultrasonic elasticity and the clinical method in evaluation of the therapeutic effect of neoadjuvant chemotherapy for breast cancer were conducted.Results1)The sensitivity,specificity and AZ of thestrain rate ratio ofultrasonic elasticity /two-dimensional ultrasound in diagnosis of breast cancer were 84.4%/78.1%,88.1%/83.3%,0.854/0.795,respectively.The value of thestrain rate ratio ofultrasonic elasticity was higher than two-dimensional ultrasound in diagnosing benign and malignant breast tumors(Z=1.999,P=0.000).2)The strain rate ratio of ultrasound elastographyofmalignant breast tumors(6.48±1.39)wassignificantly higher than that of benign breast tumors(2.01±0.92)(P <0.01).The sensitivity of strain rate ratio of ultrasound elastography in diagnosis of benign and malignant breast cancer was 78.60%,the specificity was 96.69%,the accuracy was 84.91% and the best diagnostic value was 3.54.3)The strain rate ratio of ultrasound elastography before neoadjuvant chemotherapy of breast cancer was 6.48±1.39.After receiving four cycles of neoadjuvant chemotherapy,the ratio at each cycle were as follows:NAC(1)=5.32±0.76,NAC(2)=4.93±0.95,NAC(3)=3.18±1.39 and NAC(4)=2.55±0.98.There was no statistically significant difference in the ratios between NAC(1)and NAC(2)(P>0.05).The differences in the ratios in the remaining cycles were all significantly different(P<0.05).At the same time,the strain rate ratio of ultrasound elastography of breast malignant tumors showed a downward trend with the period of neoadjuvant chemotherapy.4)To investigate the incidence of primary lesions of neoadjuvant chemotherapy after breast neoplasms were evaluated by strain rate ratio of ultrasound elastography/clinical effect: CR was 1/6,PR was 31/29,SD was 6/5,and PD was 4/ Two,ultrasonic elastic strain ratios were used to evaluate the status of breast cancer and clinical efficacy with a high degree of consistency(Kappa=0.437>0.4,P=0.000);ultrasound elastography strain rate evaluation of neoadjuvant chemotherapy efficacy and clinical efficacy evaluation has A high degree of agreement(Kappa=0.488>0.4,P=0.000),ultrasound elastography strain rate ratio neoadjuvant chemotherapy efficacy sensitivity = 85.71%,specificity = 71.42%,accuracy = 83.33%.The therapeutic effect of neoadjuvant chemotherapy in treatment of primary lesions were evaluated by strain rate ratio of ultrasound elastography/clinical method: CR was 1/6,PR was 31/29,SD was 6/5,and PD was 4/ 2.Theconsistencies betweenstrain rate ratio of ultrasound elastography and clinical methodused to diagnosebenign and malignant breast tumors as well asto evaluate therapeutic effect of neoadjuvant chemotherapy was medium and high(Kappa=0.437>0.4,P=0.000;Kappa=0.488 > 0.4,P=0.000).The sensitivity,specificity and accuracy of strain rate ratio of ultrasound elastography in evaluating therapeutic effect of neoadjuvant chemotherapy were 85.71%,71.42%and 83.33%,respectively.Conclusion 1.The sensitivity and specificity of strain rate ratio of ultrasound elastographyis high that those of two-dimensional ultrasound in diagnosis of breast malignant tumors.The clinical application value of ustrain rate ratio of ultrasound elastography for diagnosing malignant breast tumors is superior to two-dimensional ultrasound.2.The best diagnostic value ofstrain rate ratio of ultrasound elastography in diagnosing benign and malignant breast tumorswas 3.54 in this study.3.The change of thestrain rate ratio of ultrasound elastography has certain significance in the evaluation of the efficacy of neoadjuvant chemotherapy for breast cancer.4.The strain rate ratio of ultrasound elastography has guiding significance in the early evaluation of neoadjuvant chemotherapy for breast cancer.5.The strain rate ratio of ultrasound elastography in diagnosis of breast malignant tumors after neoadjuvant chemotherapy is consistent with the pathological result and has a certain clinical application value.