Evaluation value of quantitative parameters of contrast-enhanced ultrasound combined with shear wave elastography for breast cancer in axillary lymph node pathological remission after neoadjuvant chemotherapy for breast cancer

DUAN Yunan; ZHONG Na; JIAO Xiuxia; WU Jun

doi:10.20258/j.cnki.1006-9011.2025.09.018

Abstract：Objective To investigate the value of quantitative parameters of contrast-enhanced ultrasound(CEUS)com-bined with shear wave elastography(SWE)in evaluating the pathological response of axillary lymph nodes in breast cancer after neoadjuvant chemotherapy(NAC).Methods 136 patients with breast cancer treated with NAC were divided into remission group(n=55)and non-remission group(n=81)according to the pathological remission of axillary lymph nodes after NAC treat-ment and all underwent ultrasound examination.The quantitative parameters of CEUS,including lesion maximum diameter,peak systolic velocity(PSV),resistance index(RI),and peak intensity(PI),as well as SWE parameters(lesion elasticity scores)were compared between the two groups.The independent influencing factors of pathological remission of axillary lymph nodes after NAC in breast cancer were analyzed by binary logistic regression model,the curve of subjects'work characteristics(ROC)was drawn,and the combination of quantitative parameters of ultrasound imaging was analyzed.The value of SWE param-eters in evaluating pathological remission of axillary lymph nodes after NAC in breast cancer was assessed.Results Compared with the non-remission group,the remission group had lower RI,PI,and lesion elasticity scores(all P<0.05).The proportion of Ki-67 with a difference of≥30%and HER-2 negative before and after NAC treatment in the remission group were higher than those in the non-remission group(P<0.05).Multivariate logistic regression analysis found that a Ki-67 difference of≥30%before and after NAC was a protective factor for pathological remission of axillary lymph nodes after NAC(P<0.05),while,high RI,high PI,and high lesion elasticity score were independent risk factors(all P<0.05).By ROC curve analysis,RI,PI,focus elas-ticity score,and the area under the curve(AUC)of the joint assessment of pathological remission of axillary lymph nodes after NAC in breast cancer were 0.709(95%CI:0.616-0.791),0.854(95%CI:0.775-0.914),0.832(95%CI:0.750-0.896),and 0.921(95%CI:0.855-0.964),respectively.Compared with the independent assessment of each parameter,the joint assessment was more effective(Z=5.463、3.920、4.020,all P<0.05).Conclusion RI,PI,focus elasticity score are closely related to patho-logical remission of axillary lymph nodes after NAC in breast cancer,and RI,PI,focus elasticity score are more valuable in evaluating pathological remission of patients.