بررسی ارتباط یافته‌های سونوگرافیک و ماموگرافیک سرطان‌های پستان با میزان پاسخ به درمان شیمی‌درمانی نئوادجوانت و مارکر‌های ایمونوهیستوشیمی (IHC) بر اساس گزارش پاتولوژیست

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دستیار تخصصی رادیولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 استادیار و فلوشیپ پرینئاتولوژی، گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 دانشیار گروه رادیولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 استاد گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

5 استاد گروه پاتولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

10.22038/ijogi.2025.83294.6232

چکیده

مقدمه: کموتراپی نئوادجوانت با هدف کاهش سایز تومور، افزایش شانس جراحی نگه‌دارنده پستان و درمان میکرومتاستاز­های مخفی به‌کار می­ رود. مطالعه حاضر با هدف بررسی ارتباط یافته­ های رادیولوژیک اولیه بیماران در پیش‌بینی پاسخ به درمان کموتراپی بر اساس پاتولوژی انجام شد.
روش‌کار: این مطالعه توصیفی تحلیلی در سال 1403-1400 بر روی 151 نفر از بیماران مراجعه کننده به بیمارستان امید مشهد که توسط سونوگرافی و ماموگرافی برایشان تشخیص سرطان پستان گذاشته شده بود و کاندید کموتراپی نئوادجوانت بودند، انجام گرفت. میزان پاسخ به درمان کموتراپی نئوادجوانت توسط پاتولوژیست بر اساس پروتکل CAP از 0 تا 3 مشخص می­ شد. میزان مارکرهای IHC نیز توسط پاتولوژیست تعیین گردید. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 27) و آزمون‌های کروسکال والیس و من‌ویتنی انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ ها: بین میانگین her2neu و Ki67 با شکل ماموگرافیک توده و بین میزان بیان ER و PR با composition ماموگرافیک پستان ارتباط معناداری مشاهده شد (05/0>p). همچنین بین میانگین ER با شکل سونوگرافیک توده و میانگین Ki67 و ER با حاشیه سونوگرافیک توده ارتباط آماری معناداری مشاهده شد (05/0>p). حاشیه سونوگرافیک توده نیز روند کاهشی معناداری با پاسخ به کموتراپی نئوادجوانت در بیماران با سرطان پستان نشان داد (05/0>p).
نتیجه ­گیری: بین شکل ماموگرافیک توده و composition ماموگرافیک پستان با مارکر­های IHC و شکل و حاشیه سونوگرافیک توده با میزان مارکرهای IHC ارتباط آماری معناداری وجود داشت. همچنین بیماران با شکل بیضی و حاشیه میکرولبوله، واضحاً پاسخ به درمان بهتری را بر اساس پروتکل CAP نشان دادند که نشان‌دهنده پاسخ به درمان بهتر در گروه بیماران با شکل بیضی و حاشیه میکرولبوله در سونوگرافی بود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Relationship of sonographic and mammographic findings of brest cancers with the response to neoadjuvant chemotherapy and immunohistochemistry (IHC) markers based on pathologist report

نویسندگان [English]

  • Ehsan Ashtarian 1
  • Zahra Rastin 2
  • Farzaneh Khouroshi 3
  • Lida Jarahi 4
  • Amirhossein Jafarian 5
1 Resident, Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Assistant Professor and Fellowship of Perinatology, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Associate Professor, Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Professor, Department of Social Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Professor, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Neoadjuvant chemotherapy is used with aim to shrink tumors, allowing breast-conserving surgery and targeting micro-metastases. This study was performed with aim to investigate the correlation between initial radiological findings of patients to predict chemotherapy response based on pathology.
Methods: This descriptive-analytical study was conducted in 1400-1403 on 151 patients referred to Omid Hospital in Mashhad who were diagnosed with breast cancer by ultrasound and mammography and were candidates for neoadjuvant chemotherapy. The response rate to neoadjuvant chemotherapy was determined by the pathologist based on the CAP protocol from 0 to 3. The level of IHC markers was also determined by the pathologist. Data analysis was performed using SPSS statistical software (version 27) and Kruskal-Wallis and Mann-Whitney tests. A p value of less than 0.05 was considered significant.
Results: A significant correlation was observed between the mean of her2neu and Ki67 with the mammographic shape of the mass and between the expression level of ER and PR with the Brest mammographic composition (P<0.05). Also, a statistically significant correlation was observed between the mean ER with the sonographic shape of the mass and the mean Ki67 and ER with the sonographic margin of the mass (P<0.05). The sonographic margin of the mass also showed a significant decreasing trend with the response to neoadjuvant chemotherapy in patients with breast cancer (P<0.05).
Conclusion: There was a statistically significant relationship between mammographic mass shape and composition with IHC markers and sonographic mass shape and margin with the amount of IHC markers Also, patients with oval shape and micro-lobulated margin clearly showed a better response to treatment based on the CAP protocol, which indicated a better response to treatment in the group of patients with oval shape and micro-lobulated margin on ultrasound.

کلیدواژه‌ها [English]

  • Breast cancer
  • CAP protocol
  • Immunohistochemistry (IHC)
  • Mammography
  • Neoadjuvant chemotherapy

مراجع

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مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 2
اردیبهشت 1404
صفحه 45-58

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