Elastography-Assisted Evaluation Of The Clinical Application Of Complete Pathological Remission After Neoadjuvant Chemotherapy In Breast Cancer

Objective:To evaluate the diagnostic value of ultrasonography in predicting pathological complete response(PCR)after neoadjuvant chemotherapy(NAC)in breast cancer.Methods:We retrospectively analyzed the clinical data of 115 patients receiving neoadjuvant chemotherapy for breast cancer admitted to the department of breast and thyroid surgery of the first affiliated hospital of the University of South China from December 2016 to December2018.Through statistical patients using ultrasonic and breast elestography imaging measurement of the size of the lump and elastic parameters before neoadjuvant chemotherapy and after four cycle of neoadjuvant chemotherapy(calculate according to the tumor size and the size),patients with pathologic results,age,tumor size,lymph node,histological grade,clinical stage,molecular classification,menstrual status number of cycles of chemotherapy and accept the neoadjuvant chemotherapy scheme.Multivariate Logistic regression analysis was conducted to obtain the probability P value of the detection indicators(i.e,mass volume parameter cm~3,elasticity score,and the combined indicators).The P value was taken as the comprehensive index of the two-layer test,and the ROC curve was constructed.T test(Student's test)was used to compare the volume between pathological complete response(PCR)and non-pathological complete responsen(PCR)groups with the comprehensive indexes of the volume and elasticity scores as well as the volume and elasticity scores.The receiver operating characteristic curve(ROC)was reconstructed to evaluate the volume(cm~3)and elasticity score under ultrasonography as well as the diagnostic performance of PCR,and the area under the curve(AUC)was measured.The critical value is determined by Youden index.Chi-square analysis or Fisher's exact test was used to analyze the correlation between the positive rate of the two kinds of examination parameters,volume and elasticity score,and the indexes that combined the volume and elasticity score,and the patient's clinicopathological diagnostic parameters.Results:25 cases of pathological complete response,90 cases of non-pathological complete response in 115 patients.Logistic regression analysis showed that tumor size and the elastic parameter is the predictor for the PCR study found:predict whether tumor patient to PCR critical value of tumor size is 0.7142cm~3,its sensitivity and specific degrees respectively:76.0%and 90%tumor elastic critical value is 2.5(the elastic coefficient is an integral value,so the value in practical application is?2),and their sensitivity and specificity were 56.0%and97.8%,respectively.Combining tumor volume and elasticity,the critical value of the joint index was 0.3352,their sensitivity and specificity were96.0%and 95.6%,respectively.Conclusion:1.The mass volume and elasticity parameters are the predictors of pathological complete response after neoadjuvant chemotherapy for breast cancer,and the combined predictors are more sensitive;2.After the fourth cycle of neoadjuvant chemotherapy,patients'tumour with volume?0.7142cm~3,elastic parameters?2,the combined index?0.3352 were predicted to have pathological complete response.