| Objective:To explore the clinical application value of elastic ultrasound imaging in the efficacy evaluation of neoadjuvant chemotherapy for breast cancer,so as to provide a more economical and effective method for the evaluation of neoadjuvant chemotherapy and achieve precise treatment.Method:40 breast cancer patients who received neoadjuvant chemotherapy due to primary large tumor of breast cancer with or without lymph node metastasis in the Department of Breast and Thyroid Surgery of First People’s Hospital of Yunnan Province from February 2021 to February 2022 were collected prospectively.Ultrasound elastic imaging density values of the second,fourth,sixth and eighth cycles of preoperative chemotherapy were examined and measured respectively.Tumor volume and size and pathological chemotherapy response after surgery were measured too.Oneway ANOVA and binary Logistic linear regression analysis were used to analyze the elasticity maximum,minimum and average value of 40 patients at the second,fourth,sixth and eighth chemotherapy periods.Kappa consistency test was used to compare the consistency of conventional ultrasound,ultrasound elastography and their combination with pathological assessment.Results:In this research,there were 40 patients with an average age of 48.17 ±10.55.The value of x ±s reflecting tumor size decreased from 5.44±3.32 in the second cycle to 2.44±1.98 in the eighth cycle,and the maximum value of Emax decreased from 158.86 ± 74.79 to 83.43 ± 54.77.The average value of Emean decreased from87.81±37.53 to 45.58±26.68,and the minimum value of Emin decreased from 21.85±16.08 to 16.46±10.89.The results of one-way ANOVA showed that Emax,Emean and Emin values were significantly decreased after NAC treatment（P<0.05）,Emax was more significant（P<0.01）.Binary Logistic regression analysis showed that there was a linear correlation between Emax and pathological assessment after NAC treatment（P<0.05）,but there was no linear correlation between Emean,Emin and pathological assessment（P<0.05）.The consistency between ultrasound elastography and pathological assessment showed in the Kappa analysis was general（Kappa=0.479）,while the consistency between conventional ultrasound and pathological assessment was poor（Kappa=0.286）.The consistency between ultrasound elastography combined with conventional ultrasound and pathological assessment was the best（Kappa=0.771）.Conclusions:Emax,Emean and Emin values are the main indexes of elastic ultrasound imaging evaluation after neoadjuvant chemotherapy for breast cancer,and are closely related to our clinical manifestations,such as changes in tumor volume.After neoadjuvant chemotherapy,elasticity of Emax,Emean and Emin values were positively correlated with tumor volume changes,and elastic value changes of ultrasound elastography could objectively reflect the effect of chemotherapy.Ultrasound elastography has clinical application value in the evaluation of neoadjuvant chemotherapy. |
