关键词: 乳腺肿瘤, 剪切波弹性成像, 丝氨酸/苏氨酸蛋白激酶

Abstract: Objective To study the value of shear wave elastrography(SWE) combined with serine/threonine kinase1(AKT1) in predicting the efficacy and short-term prognosis of neoadjuvant chemotherapy(NC) for human epidermal growth factor receptor-2(HER2)-positive locally advanced breast cancer patients. 
Methods In total, 124 patients with HER2-positive locally advanced breast cancer were selected as research subjects. All patients received NC treatment, and the pathological complete remission(pCR) rate was recorded. The SWE parameters and positive rate of AKT1 of patients with different curative effects were compared, and the related factors affecting the pCR were analyzed. The short-term prognosis of patients with different pathological characteristics was compared. 
Results Among the 124 patients, 2 were lost to follow-up and 122 were enrolled, including 38 patients who reached the pCR, with the pCR rate of 31.15%. The follow-up time ranged from 4 to 12 months. In addition, 40 cases died and 82 cases survived. The one-year survival rate was 67.21%. Multivariate logistic analysis showed that the degree of differentiation(OR=0.614, 95%CI=0.482-0.782, P＜0.001), elastic modulus(OR=0.431, 95%CI=0.286-0.650, P＜0.001) and AKT1 positive(OR=0.565, 95%CI=0.338-0.944, P=0.029) were independent influencing factors for the curative effect of NC(P＜0.05). The area under ROC curve(AUC) of joint prediction probability of elastic modulus value + AKT1 to evaluate the pCR was higher than that of single index(P＜0.05). The 1-year survival rates of patients with different degree of differentiation, elastic modulus and AKT1 expression level were significantly different(P＜0.05). 
Conclusion SWE parameters combined with AKT1 can help to judge the NC efficacy and short-term prognosis of HER2-positive locally advanced breast cancer patients. 

Key words: breast neoplasms, shear wave elastrography, serine/threonine kinase1