| Objective:Neoadjuvant chemotherapy(NACT),as an important method for comprehensive treatment of breast cancer,plays a guiding role in adjusting chemotherapy regimens and determining the optimal timing of radical surgery for breast cancer patients.Therefore,the evaluation of efficacy after NACT has become a hot spot in clinical research.Color Doppler flow imaging(CDFI)has significant effects in evaluating the NACT efficacy and can be used as an important means to observe the NACT efficacy of breast cancer,because it can clearly show the information about tumor lesions and lymph node internal blood flow distribution,blood flow abundance and hemodynamics.SMI technology is a new type of Doppler blood flow technology,and it can effectively distinguish Doppler signals from low-speed blood flow and tissue movement,and extract low-speed blood flow information filtered by traditional Doppler ultrasound as noise so as to make low-speed microvessels visible,thus more clearly showing the microcirculation in tumor lesions.However,there are very few reports on the evaluation of NACT efficacy of breast cancer by microangiography(SMI).In this study,110 patients with breast cancer who underwent preoperative NACT in the hospital from January 2017to January 2019 were examined by SMI technology and compared with CDFI,and the study is aimed to explore the application value of SMI technology and CDFI in the evaluation of chemotherapy effects of breast cancer.Methods:From January 2017 to January 2019,110 patients with breast cancer admitted to the Second Affiliated Hospital of Anhui Medical University and receiving NACT were collected.After 4 cycles of NACT treatment,the tumor size changes of patients before and after NACT were examined,and the Adler blood flow grading showed by CDFI and SMI technology was recorded,and the chemotherapy efficacy of patients was evaluated and compared with surgical histopathology.The value of SMI technology and CDFI in evaluating the NACT effects of breast cancer was compared and analyzed by the receiver operating characteristic curve(ROC).Data were statistically analyzed by SPSS 21.0 software.P<0.05 was considered as statistical significance.Results:(1)All 110 patients were diagnosed with breast cancer under ultrasound-guided tissue biopsy.According to the evaluation criteria of Miller-Payne grading system,there were 15 cases of G1 grade,21 cases of G2 grade,22 cases of G3 grade,24 cases of G4 grade and 28 cases of G5 grade,including 36 cases of pathologically ineffective patients[32.73%(36/110)]and 74 cases of pathologically effective patients[67.27%(74/110)].(2)There were significant differences in tumor length,width,height and sum of the three diameters before and after NACT treatment among 110 breast cancer patients(P<0.001).(3)Adler blood flow grading shown by SMI and CDFI after NACT treatment was significantly improved compared with that before NACT(P<0.001),and the proportions of patients with grade 0 and grade?of Adler blood flow grading were increased significantly while the proportions of patients with grade?and grade?were decreased significantly(P<0.001).There was a statistically significant difference in the Adler blood flow grading shown by SMI or CDFI before NACT treatment(c~2=4.980,P<0.001),but there was no significant difference in the Adler blood flow grading showed by SMI or CDFI after NACT(c~2=1.950,P>0.05).(4)The Kappa values of SMI technology and CDFI in the NACT efficacy evaluation and pathology evaluation were 0.745 and 0.729respectively,with good consistency.The area under the curve,sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of SMI evaluation of NACT efficacy of breast cancer were 0.862(95%CI:0.775?0.948),94.59%(70/74),77.78%(28/36),89.09%(98/110),89.74%(70/78)and 87.50%(28/32).The area under the curve,sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of CDFI evaluation of NACT efficacy of breast cancer were 0.833(95%CI:0.736?0.930),100%(74/74),66.67%(24/36),89.09%(98/110),86.05%(74/86)and 100%(24/24).There were no significant differences in the sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of SMI or CDFI in evaluating the NACT efficacy of breast cancer(P>0.05).Conclusion:SMI and CDFI have good consistency in evaluating the NACT efficacy and histopathology of breast cancer,and they can effectively observe the changes in breast tumor lesion size before and after NACT treatment,but SMI shows better tumor microvessels than CDFI,and can be used to provide important reference opinions for development of treatment plans of breast cancer after NACT. |
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