A Novel Model Incorporating Tumor Stiffness, Blood Flow Characteristics, and Ki-67 Expression to Predict Responses After Neoadjuvant Chemotherapy in Breast Cancer
ObjectiveTo investigate the ability of tumor stiffness, tumor blood flow, and Ki-67 expression alone or in combination in predicting the pathological response to neoadjuvant chemotherapy (NACT) in breast cancer.Patients and MethodsThis prospective cohort study included 145 breast cancer patients tre...
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doaj-b25151d3c570416fb7ccc80257443d5e2020-12-08T06:52:49ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-12-011010.3389/fonc.2020.603574603574A Novel Model Incorporating Tumor Stiffness, Blood Flow Characteristics, and Ki-67 Expression to Predict Responses After Neoadjuvant Chemotherapy in Breast CancerJing Zhang0Song Gao1Qiaojin Zheng2Ye Kang3Jianyi Li4Shuo Zhang5Cong Shang6Xueying Tan7Weidong Ren8Yan Ma9Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Clinical Oncology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Pathology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Neurology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, ChinaObjectiveTo investigate the ability of tumor stiffness, tumor blood flow, and Ki-67 expression alone or in combination in predicting the pathological response to neoadjuvant chemotherapy (NACT) in breast cancer.Patients and MethodsThis prospective cohort study included 145 breast cancer patients treated with NACT. Tumor stiffness (maximum stiffness (Emax), mean stiffness (Emean)), blood score (BS), and their relative changes, were evaluated before (t0), during (t1–t5), and at the end of NACT (t6) by shear-wave elastography and optical imaging. Ki-67 expression was quantitatively evaluated by immunohistochemistry using core biopsy specimens obtained before NACT. Pathological responses were evaluated by residual cancer burden. The ability of tumor stiffness, BS, Ki-67, and predRCB—which combined ΔEmean (t2) (the relative changes in Emean after the second NACT cycle), BS2 (BS after the second NACT cycle), and Ki-67—in predicting tumor responses was compared using receiver operating characteristic curves and the Z-test.ResultsTumor stiffness and BS decreased during NACT. ΔEmean (t2), BS2, and Ki-67 had better predictive performance than other indexes in identifying a favorable response (AUC = 0.82, 0.81, and 0.80) and resistance responses (AUC = 0.85, 0.79, and 0.84), with no significant differences between the three (p > 0.05). PredRCB had better predictive performance than any parameter alone for a favorable response (AUC = 0.90) and resistance (AUC = 0.93).ConclusionTumor stiffness, BS, and Ki-67 expression showed good and similar abilities for predicting the pathological response to NACT, and predRCB was a significantly better predictor than each index alone. These results may help design therapeutic strategies for breast cancer patients undergoing NACT.https://www.frontiersin.org/articles/10.3389/fonc.2020.603574/fullblood flowbreast cancerNeoadjuvant chemotherapypredictive valueshear-wave elastography |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jing Zhang Song Gao Qiaojin Zheng Ye Kang Jianyi Li Shuo Zhang Cong Shang Xueying Tan Weidong Ren Yan Ma |
spellingShingle |
Jing Zhang Song Gao Qiaojin Zheng Ye Kang Jianyi Li Shuo Zhang Cong Shang Xueying Tan Weidong Ren Yan Ma A Novel Model Incorporating Tumor Stiffness, Blood Flow Characteristics, and Ki-67 Expression to Predict Responses After Neoadjuvant Chemotherapy in Breast Cancer Frontiers in Oncology blood flow breast cancer Neoadjuvant chemotherapy predictive value shear-wave elastography |
author_facet |
Jing Zhang Song Gao Qiaojin Zheng Ye Kang Jianyi Li Shuo Zhang Cong Shang Xueying Tan Weidong Ren Yan Ma |
author_sort |
Jing Zhang |
title |
A Novel Model Incorporating Tumor Stiffness, Blood Flow Characteristics, and Ki-67 Expression to Predict Responses After Neoadjuvant Chemotherapy in Breast Cancer |
title_short |
A Novel Model Incorporating Tumor Stiffness, Blood Flow Characteristics, and Ki-67 Expression to Predict Responses After Neoadjuvant Chemotherapy in Breast Cancer |
title_full |
A Novel Model Incorporating Tumor Stiffness, Blood Flow Characteristics, and Ki-67 Expression to Predict Responses After Neoadjuvant Chemotherapy in Breast Cancer |
title_fullStr |
A Novel Model Incorporating Tumor Stiffness, Blood Flow Characteristics, and Ki-67 Expression to Predict Responses After Neoadjuvant Chemotherapy in Breast Cancer |
title_full_unstemmed |
A Novel Model Incorporating Tumor Stiffness, Blood Flow Characteristics, and Ki-67 Expression to Predict Responses After Neoadjuvant Chemotherapy in Breast Cancer |
title_sort |
novel model incorporating tumor stiffness, blood flow characteristics, and ki-67 expression to predict responses after neoadjuvant chemotherapy in breast cancer |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2020-12-01 |
description |
ObjectiveTo investigate the ability of tumor stiffness, tumor blood flow, and Ki-67 expression alone or in combination in predicting the pathological response to neoadjuvant chemotherapy (NACT) in breast cancer.Patients and MethodsThis prospective cohort study included 145 breast cancer patients treated with NACT. Tumor stiffness (maximum stiffness (Emax), mean stiffness (Emean)), blood score (BS), and their relative changes, were evaluated before (t0), during (t1–t5), and at the end of NACT (t6) by shear-wave elastography and optical imaging. Ki-67 expression was quantitatively evaluated by immunohistochemistry using core biopsy specimens obtained before NACT. Pathological responses were evaluated by residual cancer burden. The ability of tumor stiffness, BS, Ki-67, and predRCB—which combined ΔEmean (t2) (the relative changes in Emean after the second NACT cycle), BS2 (BS after the second NACT cycle), and Ki-67—in predicting tumor responses was compared using receiver operating characteristic curves and the Z-test.ResultsTumor stiffness and BS decreased during NACT. ΔEmean (t2), BS2, and Ki-67 had better predictive performance than other indexes in identifying a favorable response (AUC = 0.82, 0.81, and 0.80) and resistance responses (AUC = 0.85, 0.79, and 0.84), with no significant differences between the three (p > 0.05). PredRCB had better predictive performance than any parameter alone for a favorable response (AUC = 0.90) and resistance (AUC = 0.93).ConclusionTumor stiffness, BS, and Ki-67 expression showed good and similar abilities for predicting the pathological response to NACT, and predRCB was a significantly better predictor than each index alone. These results may help design therapeutic strategies for breast cancer patients undergoing NACT. |
topic |
blood flow breast cancer Neoadjuvant chemotherapy predictive value shear-wave elastography |
url |
https://www.frontiersin.org/articles/10.3389/fonc.2020.603574/full |
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