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Objective:To investigate the clinical value of shear wave elastography (SWE) in predicting pathological responses to neoadjuvant chemotherapy in breast cancer.Methods:According to the postoperative pathological responses, 56 patients who received neoadjuvant chemotherapy followed by surgical excision in the Fujian Cancer Hospital from August 2019 to September 2020 were divided into responders and non-responders. The relative change rates of tumor maximum diameter(ΔD2, ΔD4) and SWE stiffness (ΔEmax2, ΔEmax4, ΔEmean2, ΔEmean4) were assessed before NAC and after different NAC cycles (t2, t4). Clinical information, including age, T, N stages, ER, PR, HER2, Ki67, and molecular subtype were also considered as the variables. The independent influencing factors of pathological responses after neoadjuvant chemotherapy were obtained by logistic regression analysis and diagnostic test was carried out.Results:There were 23 cases as responders (41.0%, 23/56), and 33 cases as non-responders (58.9%, 33/56). Results of multivariate analysis showed ΔEmax4 and HER2 index were independent influencing factors of pathological responses ( OR=1.11, P<0.001; OR=31.81, P=0.002). Area under curve of the ΔEmax4 (AUC: 0.869, 95% CI: 0.746-0.941) was higher than that of HER2 (AUC: 0.690, 95% CI: 0.545-0.834). The combination of ΔEmax4 and HER2 gave the best prediction of pathological responses (AUC 0.930, 95% CI: 0.829-0.981). the sensitivity, specificity, diagnostic accuracy, postive predictive value, and negative predictive value were 78.26%, 96.97%, 75.23%, 94.73%, and 86.49%, respectively. Conclusions:ΔEmax4 and HER2 are independent predictors of pathological responses after neoadjuvant chemotherapy for breast cancer. Combined ΔEmax4 and HER2 can improve the predictive diagnostic efficacy of pathological responses to chemotherapy for breast cancer.
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Objective To investigate the clinical value of ultrasound-guided catheterization in intraperitoneal perfusion chemotherapy for postoperative abdominal malignant tumor without ascites. Methods A retrospective analysis were performed in 146 postoperative patients with abdominal malignancies who were admitted to Fujian Cancer Hospital from April 2013 to September 2018, and there were no ascites founded in these patients before abdominal catheterization. Two hundred and seventy-nine times ultrasound-guided catheterization in intraperitoneal perfusion chemotherapy were performed under clinical guidance. Results Two hundred and seventy-seven times abdominal catheterization was completed, with a success rate of 99.3％(277/279), and the one-time success rate was 83.2％(232/279), 2 times (0.7％, 2/279) had to be abandoned for peritoneal adhesions. Fifty-three patients (36.3％, 53/146) underwent catheterization ≥ 2 times. The intraperitoneal perfusion chemotherapy was successfully completed after catheterization, no intestinal injury and bleeding occurred. Conclusions In the absence of ascites, ultrasound guided catheterization in perfusion chemotherapy is safe, reliable, simple, accurate and has a high success rate. This new approach is good for clinical application when the conventional catheterization with ascites is blocked.