Abstract:

Objective　To explore the prediction model of the effect of interventional ablation for early breast cancer based on magnetic resonance imaging (MRI) and ultrasonic elastography. Methods　Retrospective analysis was made on 126 female patients with breast cancer admitted to First Affiliated Hospital of Xi'an Medical University from January 2021 to January 2024. They were (49.46±5.17) years old. All the patients were treated with ultrasound guided radiofrequency ablation. Six months after the surgery, the patients were divided into a pathological complete remission (pCR) group and a non-pCR group according to the pathological results. The ultrasonic elastic imaging indicator [shear wave velocity (SWV)] and MRI indicators [T1 weighted (T1WI) signal, T2WI low fat suppression signal, enhanced signal, and apparent diffusion coefficient (ADC)] were compared between the two groups. The influencing factors of the effect of interventional ablation for early breast cancer were analyzed to build a prediction model for evaluating the effect of interventional ablation for early breast cancer. The data were compared between the two groups by t and χ² tests.The influencing factors were analyzed by the logistic regression model. The fitting degree was evaluated by the Hosmer-Lemeshow test. The predictive efficacy was evaluated by the receiver operating characteristic curve (ROC). Results　Among the 126 patients, 114 had pCR, and 12 had non-pCR. The maximum tumor diameter, SWV ratio of diseased side to opposite side (SWVr), T1WI low/equal signal, T2WI fat suppression high signal, and enhanced signal were the risk factors of non-pCR in interventional ablation for early breast cancer, and ADC was the protective factor (all P<0.05). The sensitivity, specificity, and area under the curve of the nomogram model for predicting non-pCR in interventional ablation for early breast cancer were 0.862, 0.874, and 0.879, respectively. Conclusion　Maximum tumor diameter, SWVr, T1WI signal, T2WI low fat suppression signal, enhanced signal, and ADC can evaluate the effect of interventional ablation for early breast cancer, and building a prediction model is helpful to identify the effect of interventional ablation for early breast cancer.

Key words:

Breast cancer, Early stage, Ablation, Ultrasonic elastography, Magnetic resonance imaging, Predictive model

摘要：

目的　探讨基于超声弹性成像和磁共振成像（MRI）构建早期乳腺癌介入消融效果的预测模型。方法　采用回顾性分析，选取2021年1月至2024年1月西安医学院第一附属医院接诊的女性早期乳腺癌患者126例，年龄（49.46±5.17）岁，所有受试者均在超声引导下行乳腺癌射频消融术治疗。术后6个月，依据病理结果分为病理完全缓解（pCR）组和非pCR组，比较两组超声弹性成像中的剪切波速度（SWV）与MRI指标［T1加权（T1WI）信号、T2WI抑脂低信号、强化信号、表观扩散系数（ADC）值］，分析早期乳腺癌介入消融效果的影响因素，构建评估早期乳腺癌介入消融效果的预测模型。组间比较采用t、χ²检验，logistic回归模型分析影响因素，Hosmer-Lemeshow检验评估拟合度，受试者操作特征曲线（ROC）评估预测效能。结果　126例乳腺癌患者中pCR 114例，非pCR 12例。肿瘤长径、病变侧与对侧的SWV比值（SWVr）、T1WI低/等信号、T2WI抑脂高信号、强化信号是早期乳腺癌介入消融非pCR的危险因素，ADC是早期乳腺癌介入消融非pCR的保护因素（均P<0.05）。列线图模型预测早期乳腺癌介入消融非pCR的灵敏度为0.862，特异度为0.874，曲线下面积为0.879。结论　肿瘤长径、SWVr、T1WI信号、T2WI抑脂低信号、强化信号、ADC值能够评估早期乳腺癌的介入消融效果，构建预测模型有助于甄别早期乳腺癌的介入消融效果。

关键词:

乳腺癌, 早期, 消融, 超声弹性成像, 磁共振成像, 预测模型