| Objective :To investigate the value of diffused Optical Tomography(DOT)in Predicting metastasis of axillary lymph of invasive breast cancer And monitoring progression of cancer neoadjuvant chemotherapy.Methods :1 A total of 369 breast lesion in 369 patients were detected by ultrasound and diffuse optical tomography(DOT)at the Fu Jian Provincal Hospital between 2014 and 2017.Histology results were served as golden reference.Study DOT finding of Synthesis Diagnostic Index(SDI),Total Hemoglobin(HBT),Dxyhemoglobin Saturation(SO2)detected in benign and Malignant breast lesion.Obtain cutoff count on the basis of ROC analysis.2 146 patients of invasive breast carcinoma divided into two groups: lymph node-positive and lymph node-negative According to histology.compared the difference of DOT finding of SDI,HBT,SO2 between two groups.Obtain cutoff count of diagnosing axillary metastasis through ROC analysis.Study the value of ultrasound combine with DOT in reducing the rate of missing diagnosis of axillary metastasis.3 45 patients were eligible for neoadjuvant chemotherapy.They were imaged before treatment and at the end of every treatment cycle with ultrasound and DOT.size,SDI,HBT,SO2 were measured in each lesion.the patients were graded in terms of their final pathologic response on the basis of the Mille Payne system(MP)as group A(G1-G3)and group B(G4,G5).analysis the correlation of change of size and change of SDI,HBT.SO2.compared variation characteristics between two groups.Results :1 The ages of 369 patients ranged from 11 to 19 years old.203 patients were histologically confirmed as benign,range from 11-77 years old,the mean age was 41.77±10.78 years old,166 patients were histologically confirmed as malignant,range from 24-79 years old,the mean age was 51.08±10.74 years old.The sizes of 203 benign lesions ranged from 3mm~52mm,the mean size was 11 mm,The sizes of 166 malignant lesions ranged from 5.00mm~78.00 mm,the mean size was 23.00 mm.The average SDI,HBT,SO2 in benign group was 109.59±79.40,134.58±100.47,0.97±0.08,in malignant group was 209.51±87.36,228.83±92.55,0.96±0.14.There were significant differences in SDI and HBT between benign lesions and malignant lesions(p<0.01),and no significant differences in SO2(p=0.70).The areas under the ROC curve of SDI,HBT,SO2 were 0.812,0.788 and 0.512.The cutoff count of SDI?HBT and SO2 were 73.50,158.50,1.17.2 146 patients were histologically confirmed as invasive breast cancer.the presence of axillary metastasis was confirmed in 82 patients,the ages ranged from 26 ~66 years old,the mean age was 50.70±7.11 years old.The sizes of lesions ranged from 7.00mm~78.00 mm,the mean size was 38.30±17.49 mm.The average SDI,HBT,SO2 were 230.96±70.23,298.05±41.75,0.97±0.09.64 patients were confirmed as lymph node-negative,the ages ranged from 27 ~79 years old,the mean age was 49.32±11.33 years old.The sizes of lesions ranged from 6mm~78mm,the mean size was 33.80±20.54 mm.The average SDI,HBT,SO2 were 197.70±79.41,209.50±88.99,0.97±0.07.There were significant differences in SDI,HBT and size between two groups(p=0.07,p=0.02,P<0.01),and no significant differences in age and SO2(p=0.83,p=0.712).The cutoff count of SDI?HBT and SO2 were 211,212.50,1.02 in diagnosing of axillary metastasis.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,AUC of US with SDI and US with HBT were 92.68%(76/82),94.92%(56/59),93.61%(132/141),96.20%(76/79),90.32%(56/62),0.933;91.46%,94.91%,92.91%,96.15%,88.89%,0.925,significantly greater than US alone(74.12%,89.83%,82.27%,91.30%,76.61%,0.825).3 The ages of 45 patients ranged from 37-63 years old,the mean age was 52.00±7.76 years old.36 patients in group A,the ages ranged from 37~63years old,the mean age was 47.80±3.81 years old,the sizes of lesions ranged from18mm~75mm,the mean size was 47.80±17.43 mm,The average SDI,HBT,SO2 were 283.04±70.32,266.71±56.66,0.96±0.06.9 patients in group B,the ages ranged from 50~59years old,the mean age was 57.42±3.05 years old,the sizes of lesions ranged from 15mm~59mm,the mean size was 44.62±16.98 mm,The average SDI,HBT,SO2 were 246.63±52.71,263.08±45.41,0.99±0.10.There were significant differences in age,size of lesion,SDI between two groups(p<0.001,p=0.030 p<0.001),and no significant differences in HBT and SO2(p=0.215,p=0.424)before treatment.There were significant differences in sizes of lesions,SDI and HBT at the end of every treatment cycle(p<0.001),and in variation characteristics of HBT at the end of the frist three treatment cycle.Conclusions :1 DOT finding of SDI and HBT contribute to the diagnosis of malignant lesion of breast.2 SDI and HBT level are preoperative predictors of axillary Nodal status,ultrasound combine with DOT can reduce the rate of missing diagnosis of axillary metastasis.3 The change of HBT during early treatment cycles can further Predict final pathologic response. |
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