| Objective:In this study,we propose to manufacture sub-continuous large pathological slices of breast specimens through Contrast-enhanced ultrasound(CEUS)technology combined with Neoadjuvant chemotherapy(NAC).To observe the tumor regression pattern of neoadjuvant chemotherapy,and to explore the accuracy of CEUS in evaluating tumor regression pattern after NAC and related influencing factors.Methods:The medical records,CEUS parameters before and after NAC,and postoperative histopathological examination results of 82 patients diagnosed with stage ⅡA-ⅢC breast cancer by puncture(January 2018 to March 2023)admitted to the Breast Surgery Department of Shanxi Cancer Hospital were reviewed and collected.The 52 cases with significant NAC efficacy assessed by CEUS were divided into two groups,honeycomb scattered regression and centripetal regression,which were confirmed by large pathological sections of tumor specimens.To analyze the consistency between the results of CEUS in evaluating the efficacy of NAC and the "gold standard" of postoperative pathology.The correlation parameters of CEUS before and after NAC were compared.Univariate and multivariate analysis of specific diagnostic indicators of CEUS in different tumor withdrawal patterns.Results:There was no significant difference between the volume measured by CEUS after NAC and the postoperative pathological volume in 82 patients with breast cancer(P >0.05).There were 52 cases(63.4%)with significant effect and 30 cases(36.6%)with no significant effect on NAC evaluated by CEUS.There were 53 cases(64.6%)with significant results and 29 cases(35.4%)with no significant results.46 cases(56.1%),25cases(30.5%),and 5 cases(6.2%)were evaluated as significant by CEUS and non-significant by postoperative pathology.There were 6 cases(7.2%)where the CEUS evaluation of NAC was not significant and the postoperative pathological evaluation was significant.The efficacy of NAC evaluated by CEUS was highly consistent with the postoperative pathological "gold standard".Comparison of each CEUS parameter before and after NAC showed that Arriva time(AT)(13.00,12.00)before and after NAC had statistical significance(P < 0.05),Time to peak(TTP)(22.00,22.50)and Mean transit time(MTT)(32.00,35.50)were not significantly different before and after NAC(P >0.05).The arrival time(AT)of CEUS parameter changed significantly before and after NAC.Pathological return comparison of CEUS parameters between The significant and non-significant groups showed that The difference in arrival time(d AT)(1.00,1.00),The difference in time to peak(d TTP)(2.00,-1.00),The difference in mean transit time(d MTT)(2.00,-3.00).In this study,the difference of all CEUS parameters in pathological return showed no difference between the group with significant effect and the group with no significant effect(P > 0.05).52 cases of effective chemotherapy(CR+PR)evaluated by ultrasound were divided into honeycomb dispersed retreat group and centripetal retreat group according to pathological returns.Univariate analysis showed that there were no significant differences in age,body mass index(BMI),tumor location and menopausal status between the cellulitic and centripetal retraction groups.d TTP and d MTT were associated with tumor regression pattern.Logistic multivariate regression analysis showed that only d TTP was associated with tumor regression pattern(B =-0.148,OR = 0.862,P < 0.05).Conclusion:There was no significant difference between the tumor volume measured by CEUS and that measured by pathology.The results of CEUS in evaluating the efficacy of NAC were consistent with the results of postoperative pathological "gold standard" evaluation,and the arrival time(AT)in CEUS parameters had good evaluation value.TTP(peak to time)is a promising CEUS parameter for predicting tumor regression pattern. |
