Ann Surg：HR状况与HER2靶向药物影响核磁共振成像准确性

即将于2013年1月出版的《外科学年鉴》(Annals of Surgery)杂志发表了韩国国立首尔大学医院Hyeong-Gon Moon博士等人的一项研究结果，该研究针对在进行新辅助治疗后，核磁共振成像(MRI)的准确性是否受原发性乳腺癌相关分子特征以及以人表皮生长因子受体2(HER2)为靶点的药物影响进行了考察。

对于新辅助治疗后，影响乳腺癌核磁共振成像准确性因素的更深入理解，有助于核磁共振成像更契合于新辅助治疗后的手术范围确定。

该项研究对463例患者的影像学以及临床病理资料进行了分析，这些患者均曾接受过新辅助治疗。该研究目的为，考察分子亚型以及应用靶向治疗是否与核磁共振成像在预测肿瘤残存程度方面的准确性变化有关。

研究人员发现，核磁共振成像在预测三阴性乳腺癌肿瘤残存程度方面的准确性最高，而在预测管腔A亚型肿瘤的准确性最差(皮尔森相关系数分别为0.754与0.531)。多变量分析表明，雌激素受体(ER)状态为影响核磁共振成像准确性的独立因素。而对于HER2表达出现扩增的肿瘤，HER2靶向药物应用与核磁共振成像预测准确性降低有关。

研究人员认为，核磁共振成像在预测经新辅助治疗后且ER呈阳性的肿瘤残存程度方面准确性最低。而对于HER2呈阳性的肿瘤，应用HER2靶向药物可降低新辅助治疗后，核磁共振成像的准确率。因此研究人员建议，对患者进行新辅助化疗后，在确定保乳范围时，应对这些因素进行考虑。

与核磁共振相关的拓展阅读：

• BJR：核磁共振成像可用来检测癌细胞的骨转移
• Nueron：新核磁共振技术或能预测痴呆进程
更多信息请点击：有关核磁共振更多资讯

DOI:10.1097/SLA.0b013e3182686bd9
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Breast Cancer Molecular Phenotype and the Use of HER2-Targeted Agents Influence the Accuracy of Breast MRI After Neoadjuvant Chemotherapy.

Moon, Hyeong-Gon MD *; Han, Wonshik MD, PhD *,+; Ahn, Soo Kyung MD *; Cho, Nariya MD, PhD ++; Moon, Woo Kyung MD, PhD ++; Im, Seock-Ah MD, PhD +,[S]; Park, In Ae MD, PhD ||; Noh, Dong-Young MD, PhD *,+

Objective: To investigate whether the accuracy of magnetic resonance imaging (MRI) after neoadjuvant systemic therapy (NST) is affected by molecular features of primary breast cancer and the use of human epidermal growth factor receptor 2 (HER2)-targeted agents. Background: Improved understanding of factors affecting the accuracy of breast MRI after NST can lead to more tailored use of MRI in deciding surgical extent after NST. Methods: We analyzed the imaging and clinicopathological data of 463 patients who underwent NST. We aimed to investigate whether the molecular subtypes, and the use of targeted therapies, were associated with changes in the accuracy of MRI predicting residual tumor extent. Results: The accuracy of MRI predicting the residual tumor extent was most accurate in triple-negative breast cancer and was least accurate in Luminal A subtype (Pearson correlation coefficient of 0.754 and 0.531, respectively). Multivariate analysis suggested estrogen receptor (ER) status as an independent factor influencing the MRI accuracy. In HER2-amplified tumors, the use of HER2-targeted agents was associated with a less accurate MRI prediction. Conclusions: The accuracy of MRI in predicting residual tumor extent was lowest in ER-positive tumors treated with NST. In HER2-positive tumors, the use of HER2-targeted agents resulted in a less accurate MRI after NST. These factors should be considered for deciding the extent of breast conservation after neoadjuvant chemotherapy.