کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5526832 | 1547064 | 2016 | 16 صفحه PDF | دانلود رایگان |
- A novel predictive modality combining the pathological marker with breast imaging was first developed using a multivariable linear regression model.
- The pre-treatment Ki-67 index and ÎEmean (t2) are independent each other in predicting the degree of neoadjuvant chemotherapy (NAC) responses.
- The combination of the relative change of the shear wave elastography (SWE) parameter after two NAC cycles and pre-treatment Ki-67 is an efficient protocol for predicting NAC responses.
- The potential utility for adding Ki-67 to SWE parameters may facilitate tailoring therapy to breast cancers.
PurposeThis study evaluated shear wave elastography (SWE) and SWE combined with the Ki-67 index as novel predictive modalities for the pathological response of invasive breast cancer to neoadjuvant chemotherapy (NAC).MethodsThe prospective study recruited 66 eligible patients from July 2014 to November 2015. Tumour stiffness, which corresponds with tumour progression and invasiveness, was assessed by quantitative SWE 1 d before biopsy (time point t0, elasticity E0), 1 d before next NAC cycle (t1ât5, E1âE5), and 1 d before surgery (t6, E6). The relative changes in SWE parameters after the first and second NAC cycles were considered as the variables [ÎE (t1), ÎE (t2)]. The pathological response was classified according to the residual cancer burden (RCB) protocol. Correlations between RCB scores and variables were evaluated. The predictive diagnostic performances of SWE parameters, Ki-67 index, and the predictive RCB (predRCB) score determined by a linear regression model were compared.ResultsSome immunohistochemical and molecular factors and SWE parameters were significantly different among the three RCB groups. The ÎEmean (t2) and Ki-67 had significantly better diagnostic performance than other parameters regarding predicting the pathological response (the RCB-I response and RCB-III resistance). However, the correlation between ÎEmean (t2) and Ki-67 index was significantly weaker as a diagnostic predictor (r = 0.29). We generated a new predictive modality, predRCB, which is a multivariable linear regression model that combines ÎEmean (t2) and the Ki-67 index. The predRCB modality showed better diagnostic performance than SWE parameters and Ki-67 index alone.ConclusionOur findings highlight the potential utility for adding the Ki-67 index to the SWE results, which may improve the predictive power of SWE and facilitate personalising the treatment regimens of patients with breast cancer. These results should be validated in the future by performing a multicentre prospective study with a larger cohort.
Journal: European Journal of Cancer - Volume 69, December 2016, Pages 86-101