Correlation between characteristics of multimodal ultrasound and postoperative pathological remission and expression of BCL-2 in breast cancer patients with neoadjuvant chemotherapy / 中华内分泌外科杂志

ABSTRACT

Objective:To explore the characteristics of multimodal ultrasound before neoadjuvant chemotherapy (NAC) and the degree of postoperative pathological remission and B-cell lymphoma-2 (BCL-2) .Methods:From Jan. 2018 to Dec. 2020, female breast cancer patients who underwent breast-conserving or total mastectomy surgery at Shaanxi Hospital of traditional Chinese Medicine were selected as the research objects. Routine ultrasound, automatic breast full-volume imaging, and contrast-enhanced ultrasound were performed before chemotherapy. The postoperative pathological remission was evaluated according to Miller and Payne’s modified pathological response grading standard. The expression of BCL-2 in breast cancer tissue was detected by immunohistochemistry. Univariate analysis was performed on the characteristics of MHR, NMHR and bcl-2 with different expression status. Then, binary Logistic regression was used to analyze the significant variables in univariate analysis.Results:Among 186 patients, 84 patients (45.2%) were in MHR group and 102 patients (54.8%) in NMHR group after NAC surgery. The maximum diameter of mass in NMRH group was > 4 cm. The proportion of CM, irregular shape of mass, microcalcification, high enhancement of CEUS and perfusion defect (62.7%, 62.7%, 70.6%, 62.7%, 66.7%) was significantly higher than that of MRH group (38.1%, 40.5%, 39.3%, 41.7%, 31.0%, P<0.05) . The proportion of irregular shape, microcalcification, Alder blood flow grade 2-3, hyperenhancement and peripheral radiation enhancement in low bcl-2 expression patients (65.1%, 69.8%, 65.1%, 71.7%, 72.6%, respectively) was significantly higher than that in high Bcl-2 expression patients (36.2%, 38.7%, 27.5%, 28.7%, 38.8% respectively) (all P<0.05) . Multivariate Logistic analysis showed that irregular masses, with microcalcifications, and high CEUS performance were independent risk factors for NMHR (all P<0.05) ; irregular masses, with microcalcifications, and CEUS manifestations of peripheral radial enhancement were independent risk factors for low expression of BCL-2 (all P<0.05) . Conclusion:Multimodal ultrasound features can be used to predict the degree of pathological remission and the expression of BCL-2 in breast cancer patients with NAC, which helps to select treatment options and predict the prognosis of patients.