The Application Of High Intensity Focused Ultrasound Ablation In The Adjuvant Treatment Of Breast Cancer Before Surgery

ObjectiveTo investigate the therapeutic efficacy of breast cancer treated with highintensity focused ultrasound (HIFU) ablation ang neoadjuvant chemotherapyon the changes of cellular immune function and changes in invasion andmetastasis of indicators.MethodsTo choose60cases of female breast cancer patients who met theinclusion criteria between the period July2010to December2011, all patientswere diagnosed by biopsy. Patients and their families were informed consentrequirements of the HIFU treatment or neoadjuvant chemotherapy. Eventuallythe patients who meet the standards were randomly divided into HIFU ablationgroup (Group I n=30) and the neoadjuvant chemotherapy group (Group II n=30). The two groups of patients were not statistically different in terms of age,disease duration, tumor size. Another selected30cases of the same periodin hospitalized patients with benign breast disease to served as controls.Respectively before1-2days HIFU and neoadjuvant chemotherapy startingtreatment,10-14days after the end of treatment (preoperative) and thecontrol group preoperative fasting peripheral venous blood collected2mldetected by flow cytometry of T lymphocyte subsets, another peripheralvenous blood5ml after centrifugation, the supernatant was collected and put in-20℃refrigerator, to be unified measured by ELISA for serum levels of VEGF and MMP-9, while tested the liver and kidney function, observed the sideeffects of medication and treatment and recorded, applicated Karnofskyfunctional status scale score of patients. After the end of adjuvant therapy inbreast cancer patients,all patients underwent a modified radical mastectomy.SPSS13.0statistical software for data analysis and processing ofmeasurement data were expressed as mean±standard deviation, t test wasused, the difference was statistically significant with P <0.05.Results1、After the ablation of HIFU the gray values of breast cancer tissue underultrasound increased with blood flow signal disappearing, and the lightmicroscope showed complete coagulation necrosis; the foci ultrasound afterneoadjuvant chemotherapy visible volume over the previous narrow boundaryclearly while blood flow signal reduces, and the light microscope showedcancer cells scattered with atypia decreasing, showing that the inflammatoryresponse.2、The levels of CD3+, CD4+and the ratio of CD4/CD8of Group I, group IIpre-treatment are significantly lower than the control group (P <0.05), whilethe differences of CD8+cell has no statistical significance (P>0.05); Afterthe ablation the levels of CD3+, CD4+and the ratio of CD4/CD8of Group Iwas significantly higher than without ablation (P <0.05), the levels of CD8+cells was significantly lower than without ablation (P <0.05); the differencesof the levels of CD3+, CD4+and the ratio of CD4/CD8of group II has nostatistical significance (P>0.05); The levels of CD3+, CD4+and the ratio ofCD4/CD8of Group I were significantly higher than group II after chemotherapy(P <0.05).3、The levels of serum VEGF and MMP-9of Group I, group II pre-treatmentwere significantly higher than that of the control group (P <0.05). After theablation of the HIFU, serum VEGF and MMP-9levels of group I wassignificantly lower (P <0.05), after chemotherapy the serum VEGF and MMP -9levels of group II than prior was significantly reduced too (P <0.05), afterablation of the group I was no significant difference in serum VEGF andMMP-9level with Group II after chemotherapy (P>0.05).4、After the treatment of HIFU the patients′quality of life does not changesignificantly (P>0.05), after the treatment of neoadjuvant chemotherapypatients′quality of life significantly decreased (P<0.05).The preoperativeaverage treatment time was significantly shorter in the HIFU group than theneoadjuvant chemotherapy group (P <0.05).Conclusions1、High-intensity focused ultrasound ablation can significantly improve thecellular immune function of patients with breast cancer in the short term, whilecellular immune function in patients after neoadjuvant chemotherapy had nosignificant effect.2、High-intensity focused ultrasound ablation and neoadjuvant chemotherapycan both make breast cancer patients with serum VEGF and MMP-9concentrations significantly decreased in short-term, but can not be reduced tonormal.3、HIFU as a new kind of preoperative adjuvant therapy can significantlyshorten the preoperative treatment time, and has significant efficacy but nosignificant effect on the quality of life.4、As a new kind of tumor minimally invasive treatment, It is feasible for HIFUto be applied to the preoperative adjuvant therapy of breast cancer.