摘要
目的 对99Tcm 甲氧基异丁基异腈 (MIBI)乳腺显像真阳性患者的肿瘤99Tcm MIBI摄取程度与腋窝淋巴结转移、组织分级、增殖细胞核抗原 (PCNA)、雌激素受体 (ER)、孕激素受体 (PR)、c erbB 2、p5 3等预后因子之间的关系进行研究。方法 44例99Tcm MIBI乳腺显像真阳性的患者 ,平均年龄 5 4.9岁。对显像阳性的肿块计算肿块感兴趣区 (ROI)与对侧正常相应部位放射性计数比值 (T N)。病理检查诊断按照HE染色和ER、PR、PCNA、p5 3和c erbB 2的免疫组织化学染色。根据WHO标准并参照Bloom Richardson标准对HE染色切片进行组织学分级 ;并对肿瘤细胞PCNA免疫组织化学染色核染色的数目和形态进行Ⅰ～Ⅲ级评分 ;余免疫组织化学染色项目仅以阳性与否进行判别。结果 肿瘤T N值与肿瘤的组织分级、腋窝淋巴结转移、PCNA和c erbB 2之间经非参数相关性分析 ,相关系数分别为 0 .44 6 ,0 .2 2 4,0 .32 3和 0 .332 ,P值分别为 0 .0 0 1,0 .0 38,0 .0 0 4和 0 .0 0 4。余各指标差异无显著性。病理组织分级为Ⅰ～Ⅲ级的肿瘤T N值分别为 1.2 4± 0 .13,1.42± 0 .18和 1.6 1± 0 .30 ,经方差分析Ⅰ级和Ⅲ级之间差异有显著性 (P =0 .0 0 1) ;有和无腋窝淋巴结转移乳腺癌的T N值为1 5 4± 0 .2 4和 1.39± 0 .2 3(P =0 0 2 6 )。
Objective Assessment of correlation between 99 Tc m-MIBI uptake and some prognostic factors of breast cancer. The following prognostic factors were included in this study: axillary node involvement, grading of tumor with WHO standard, proliferating cell nuclear antigen (PCNA), oestrogen and progesterone receptor (ER, PR) status, c-erbB-2 antigen expression and p53 protein. Methods Forty-four patients were enrolled in this study confirmed as with primary breast cancers. Mean age of the patients was 54.9 years. Scintimammography was performed after intravenous injection of 740～1 110 MBq of 99 Tc m-MIBI. At 5～10 min after injection standard planar images were obtained in anterior supine and prone lateral views. Assessment of correlation between the known prognostic factors of breast cancer and the uptake of MIBI (evaluated as a tumor to mirror normal ratio, T/N ratio was performed using non-parametric (Kendalltau correlation) statistical analysis. Results There was positive correlation between T/N ratio 99 Tc m-MIBI and the grade of the breast tumor ( r=0.446,P =0.001),presence of axillary node involvement ( r=0.224,P =0.038), the grade of PCNA ( r=0.323, P= 0.004) and also the status of c-erbB-2 antigen expression ( r=0.332, P=0.0 04), respectively. The remaining prognostic factors showed no obvious correlation with T/N ratio 99 Tc m-MIBI. T/N ratio of breast cancer of grade Ⅰ～Ⅲ were 1.24±0.13,1.42±0.18 and 1.61±0.30, respectively. There was statistical significance between T/N ratio of grade Ⅰ and grade Ⅲ, P =0.001. T/N ratio of with/ without involvement of axillary nodes was 1.54±0.24 and 1.39±0.23, P =0.026. Conclusions Patients who presented with high grade of malignancy had higher uptake of radiotracer. Also those with higher uptake of radiotracer often had axillary node involvement. This would suggest that more aggressive tumors have higher uptake of 99 Tc m-MIBI. Finally, this study suggests correlation between in vivo uptake of 99 Tc m-MIBI and some of the known prognostic factors of breast cancer.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2002年第1期19-21,共3页
Chinese Journal of Nuclear Medicine
