^(99m)Tc-MIBI乳腺显像评价乳腺癌新辅助化疗效果的临床价值  

Clinical value of ^(99m)Tc-MIBI breast imaging in the assessment of neoadjuvant chemotherapy for breast cancer

作　　者：贾莉[1,2] 邹天宁[1,3] 夏正武[4] 刘鹏杰[1,2] 邓智勇[1,2] 

机构地区：[1]昆明医科大学第三附属医院 [2]云南省肿瘤医院核医学科,云南昆明650118 [3]云南省肿瘤医院乳腺科,云南昆明650118 [4]解放军昆明总医院检验科,云南昆明650032

出　　处：《现代医学》2014年第1期4-8,共5页Modern Medical Journal

基　　金：云南省教育厅科学研究基金(09y0171)

摘　　要：目的:探讨99mTc-MIBI显像评价乳腺癌新辅助化疗(NCT)效果的临床价值。方法:未经手术的50例局部进展期乳腺癌(LABC)患者化疗前、后分别行临床触诊、彩色多普勒超声、钼靶及99mTc-MIBI显像检查,术后对乳腺癌标本行病理检查及P-糖蛋白(P-gP)、增殖细胞核抗原(PCNA)免疫组织化学染色。以99mTcMIBI早期显像的核素肿瘤反应(STR)>50%为有效标准,临床疗效参照WHO标准评价。化疗后肿瘤细胞病理形态学改变以Ⅰ级定为弱效,Ⅱ、Ⅲ级定为显效。结果:以病理检查为标准,99mTc-MIBI显像评价NCT疗效的灵敏度、特异性和准确性高于临床触诊及钼靶检查,与彩色多普勒超声检查相似。99mTc-MIBI摄取与PCNA水平相关,而与治疗后P-gP水平无关。结论:99mTc-MIBI显像可有效评价LABC患者术前NCT疗效。Objective： To discuss the clinical value of 99mTe-MIBI image on neoadjuvant chemotherapy for breast cancer（NCT）. Methods： Fifty cases of locally advanced breast cancer（LABC） without surgery were palpated to measuring the largest tumor diameter, examined by Color Doppler Ultrasonography, Mammography and 99m Te- MIBI imaging before and after chemotherapy. Pathological examination and immunostaining of P- glycoprotein （ p- gp）, proliferating ceil nuclear antigen （PCNA） expression were carried out after surgery. In early 99mTe- MIBI phase, scintigraphic tumor response（STR） 〉 50% was as effective standard. The clinical efficacy was be evaluated by WHO standard. The I grade was defined as weakly effective and the II or III grade pathological changes after chemotherapy were defined as markedly effective. Results： The pathological examination as the standard, the sensitivity, specificity and accuracy of 99mTc-MIBI imaging to evaluating the effect of NCT were higher than clinical palpation and Mammography,and was similar with Color Doppler Ultrasonography. The intake of 99mTc-MIBI were correlated with PCNA level, but without P-gP level of after treatment. Conclusion： 99mTc-MIBI imaging can be effectively to evaluate the effectiveness of NCT for LABC patients before operation.

关 键 词：乳腺癌 99MTC-MIBI显像 新辅助化疗(NCT) 

分 类 号：R817.4[医药卫生—影像医学与核医学]