摘要
目的:探讨99mTc-MIBI显像评价乳腺癌新辅助化疗(NCT)疗效及预后的临床价值。方法:57例乳腺癌患者NCT前及2个周期(30例)、3个周期(57例)NCT后分别行乳腺99mTc-MIBI显像。肿瘤部位摄取采用靶和非靶比值(T/N)表示,术后行乳腺癌病理化疗反应分析。以NCT后T/N比值降低百分率>30%为判断化疗有效的阈值,将结果与病理检查结果对比,评价其诊断效能。根据该判断阈将患者分为显像有效组和无效组,进行临床随访,分析两组无进展生存时间(PFS)。结果:2个周期NCT后,99mTc-MIBI显像评价疗效的灵敏度、特异性和准确性分别为89%、83%和86%,阴性和阳性预测值分别为88%和83%,与对3个周期NCT疗效评价的效能差异无统计学意义,P>0.05。显像示有效组平均PFS为46.93个月,显像示无效组平均PFS为35.76个月,两组差异有统计学意义,P<0.05。结论:99mTc-MIBI显像对评价乳腺癌NCT反应、估计预后具有临床应用价值。
OBJECTIVE：To investigate the value of 99mTc-MIBI imaging in evaluativing the response to neoadjuvant chemotherapy （NCT） and predicting the prognosis of patients with breast cancer. METHODS：99mTc-MIBI imaging for breast was performed in 57 patients with breast carcinoma before NCT and after 2 cycles（30 cases） or 3 cycles （57 cases）of NCT respectively. 99mTc -MIBI uptake in primary tumor was quantified by using the lesion-to-normal breast ratio （T/N ）,The response of breast carcinoma to NCT was determined by means of pathological assay after surgery. By using a decrease of T/N value30% after NCT as a threshold for evaluating the chemotherapy response,and all the results were compared with the pathologic study. All the patients were divided into two groups,responders and non-responders by the threshold,and followed up. The progression free survival （PFS） analysis was undertaken in the two groups. RESULTS：The sensitivity,specificity and accuracy of 99mTc-MIBI imaging for evaluating the effect of 2 cycles of NCT were 89%,83% and 86%,respectively. The negative and positive predictive values were 88% and 83%,respectively. There was no significant difference in the above-mentioned efficiency indexes between 2 and 3 cycles of NCT（P0.05）. The average PFS in the groups of responders and non-responders were 46.93 and 35.76 months,respectively,which was significantly different（P0.05）. CONCLUSION：99mTc-MIBI imaging has a clinical value to evaluate the chemotherapy response and the prognosis in primary breast cancer in early stage.
出处
《中华肿瘤防治杂志》
CAS
2009年第24期1935-1938,共4页
Chinese Journal of Cancer Prevention and Treatment
基金
江西省科技厅基金资助项目(200110300102)
关键词
乳腺肿瘤
放射性核素显像
甲氧基异丁基异腈
新辅助化疗
breast neoplasms
radionuclide imaging
methoxyisobutylisonitrile
neoadjuvant chemotherapy
