关晏星,雷秋模,熊秋云,曹亚丽,欧阳军,瞿伟,杨晓青,张青,张庆,江美英,楼捷,潘志敏.乳腺癌新辅助化疗后残留肿瘤99Tcm-MIBI摄取与预后因素的关系[J].中国医学影像技术,2007,23(6):921~924
乳腺癌新辅助化疗后残留肿瘤99Tcm-MIBI摄取与预后因素的关系
Correlation between residual tumor uptake of 99Tcm-sestamibi and prognostic factors after neoadjuvant chemotherapy for breast cancer
投稿时间:2006-12-08  修订日期:2007-05-30
DOI:
中文关键词:  乳腺肿瘤  新辅助化疗  甲氧基异丁基异腈  预后
英文关键词:Breast neoplasms  Neoadjuvant chemotherapy  Methoxyisobutylisonitrile  Prognosis
基金项目:本文受江西省科技厅计划项目资助(200110300102)。
作者单位
关晏星 南昌大学第一附属医院核医学科,江西 南昌 330006 
雷秋模 南昌市第三医院乳腺外科,江西 南昌 330006 
熊秋云 南昌市第三医院乳腺外科,江西 南昌 330006 
曹亚丽 南昌市第三医院乳腺外科,江西 南昌 330006 
欧阳军 南昌大学第一附属医院核医学科,江西 南昌 330006 
瞿伟 南昌市第三医院乳腺外科,江西 南昌 330006 
杨晓青 南昌大学第一附属医院核医学科,江西 南昌 330006 
张青 南昌大学第一附属医院核医学科,江西 南昌 330006 
张庆 南昌大学第一附属医院核医学科,江西 南昌 330006 
江美英 南昌大学第一附属医院核医学科,江西 南昌 330006 
楼捷 南昌大学第一附属医院核医学科,江西 南昌 330006 
潘志敏 南昌大学第一附属医院核医学科,江西 南昌 330006 
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中文摘要:
      目的 探讨乳腺癌新辅助化疗后残留肿瘤99Tcm-MIBI显像估计患者预后因素的价值。方法 50例乳腺癌患者接受术前化疗(环磷酰胺+氨甲喋呤+5氟尿嘧啶3个疗程或环磷酰胺+表阿毒素+5氟尿嘧啶2个疗程),均进行99Tcm-MIBI 早期和延迟乳腺显像,利用感兴趣区技术测定肿瘤部位(T)与对侧正常乳腺组织(N)早期、晚期放射性摄取比值(T/N(e)、T/N(d),计算滞留指数(RI)。手术切除乳腺癌组织和腋窝淋巴结做病理分析,尺量切除下肿瘤的最大长径。分析99Tcm-MIBI摄取与病理化疗反应程度、残留腋淋巴结转移数、残余肿瘤大小的关系。结果 残余乳腺癌99Tcm-MIBI的T/N(e)及RI在病理反应Ⅰ级组明显高于Ⅱ级和Ⅲ级组,T/N(e)在Ⅱ级组明显高于Ⅲ级组(P均<0.05)。T/N(e)在残余肿块最大长径≤2 cm组明显低于>2~5.9 cm组和≥6 cm(P均<0.05)。T/N(e)及RI在残留转移腋淋巴结数≥4个组明显高于1~3个组(P<0.05)。99Tcm-MIBI早期摄取低且滞留少,提示患者预后良好,反之,预后不良。结论 新辅助化疗后残留肿瘤99Tcm-MIBI显像有助于评估患者预后因素,为术后制定化疗方案提供参考。
英文摘要:
      Objective To evaluate the value of 99Tcm-methoxyisobutylisonitrile (MIBI) imaging in predicting prognosis of patients with the breast cancer after neoadjuvant chemotherapy. Methods Fifty patients with breast carcinoma underwent the neoajuvant chemotherapy (three courses of treatment: Cyclophosphamide + Methotrexate + 5-Fluorouracil, or two courses of treatment: Cyclophosphamide + Epirubicin +5-Fluorouracil). After chemotherapy, early and delayed imagings were performed. And T/N uptake ratios in early and delayed imaging and retention index (RI) were measured and calculated on each case. The cancer tissue and axillary lymph nodes were surgically removed, and were determined by pathological essay. The largest diameters of residual tumors were measured. The correlation between 99Tcm-MIBI uptake of residual tumor and pathologic chemotherapy response, residual axillary lymph nodes metastases and tumors size were analysed. Results The early T/N ratios and RI were significantly increasing in tumors withⅠgrade chemotherapy response than those of Ⅱand Ⅲ grade (P<0.05). The early T/N ratio was significantly increasing in tumors with Ⅱ grade chemotherapy response than that of Ⅲ grade (P<0.01). The early T/N ratios were significantly decreasing in tumors with diameter ≤2 cm than those of >2-5.9 cm and ≥6 cm (P<0.05). The early T/N ratios and retention index were significantly higher in the patients with ≥4 lymph nods of metastasis than that with 1~3 (P<0.05). The decreased early uptake and retention of 99Tcm-MIBI predicted the well prognosis of patients. The high early uptake and retention rate predicted poor prognosis of patients. Conclusion 99Tcm-MIBI imaging after neoadjuvant chemotherapy may be valuable in predicting prognosis factors of patients with breast cancer.
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