^99Tc^m-3PRGD2SPECT/CT显像半定量参数与乳腺癌临床病理特征的关系  

Relationship between the semi-quantitative index of ^99Tc^m-3PRGD2 SPECT/CT imaging and clinical pathological features of breast cancer

作　　者：刘海燕[1] 李万婷[1] 秦丽军 崔雅丽[1] 牛静[1] 武志芳[1] 刘静[2] 张国琛[4] 任媛[3] 崔永萍 李思进[1] Liu Haiyan;Li Wanting;Qin Lijun;Cui Yali;Niu Jing;Wu Zhifang;Liu Jing;Zhang Guochen;Ren Yuan;Cui Yongping;Li Sijin(Molecular Imaging Precision Medical Collaborative Innovation Center,Department of Nuclear Medicine,First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Nuclear Medicine,Tumor Hospital of Shanxi,Taiyuan 030013,China;Department of General Surgery,First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Breast Surgery,Tumor Hospital of Shanxi,Taiyuan 030013,China;Cellular Physiology Key Laboratory of Ministry of Education,Translational Medicine Research Center,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院核医学科、山西省分子影像协同创新中心,太原030001 [2]山西医科大学第一医院普外科、山西省分子影像协同创新中心,太原030001 [3]山西省肿瘤医院院核医学科,太原030013 [4]山西省肿瘤医院院乳腺科,太原030013 [5]山西医科大学转化医学研究中心、细胞生理学省部共建教育部重点实验室,太原030001

出　　处：《中华核医学与分子影像杂志》2018年第12期786-789,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：山西省卫生和计划生育委员会科研课题(2015036);山西医科大学大学生创新创业校级项目(20170823).

摘　　要：目的探讨^99Tc^m-联肼尼克酰胺-3聚乙二醇-精氨酸-甘氨酸-天冬氨酸环肽二聚体(^99Tc^m-3PRGD2)SPECT/CT显像肿瘤/正常组织放射性(T/NT)比值与乳腺癌临床病理特征之间的关系。方法前瞻性纳入2016年10月至2017年6月疑诊乳腺恶性结节或肿块的女性患者45例,年龄39~76(53.0±9.5)岁。患者于穿刺和手术前行^99Tc^m-3PRGD2SPECT/CT显像。所有病例均有病理结果,并通过免疫组织化学检查和荧光原位杂交技术(FISH)获得雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)、细胞增殖核抗原Ki-67表达、微血管密度(MVD)情况。采用两样本t检验和Kruskal-WallisH检验比较数据差异。结果病理证实45例中35例为浸润性导管癌,其中Ⅰ期7例,ⅡA期11例,ⅡB期17例;LuminalA型6例,LuminalB型9例,ERBB2+型9例,Basal-like型11例。ⅡB期患者T/NT值(4.54±1.46)高于Ⅰ期、ⅡA期患者的T/NT值(3.32±1.72;t=-2.24,P<0.05);ERBB2+型患者T/NT值为5.80(3.90,6.70),明显高于Basal-like型的2.80(2.20,3.50)(H=11.06,χ^2=15.31,均P<0.05);淋巴结转移阳性组较阴性组、HER-2阳性组较阴性组均T/NT值较高(t值:-3.99、-2.51,均P<0.05)。HER-2阳性组MVD高于HER-2阴性组(t=7.13,P<0.01)。结论^99Tc^m-3PRGD2SPECT/CT显像病灶T/NT值与乳腺癌TNM分期、淋巴结转移以及HER-2有关。Objective To investigate the tumor/non-tumor (T/NT) ratio during ^99Tc^m-hydrazinonicotinamide(HYNIC)-(poly-(ethylene glycol), PEG)4-Glu(cyclo(Arg-Gly-Asp-D-Phe-Lys(PEG4)))2 (^99Tc^m-3PRGD2) SPECT/CT imaging and clinical pathological features of breast cancer. Methods Forty-five female patients (age range: 39-76 (53.0±9.5) years) with suspected breast malignant nodules or masses from October 2016 to June 2017 were prospectively enrolled. Patients underwent ^99Tc^m-3PRGD2 SPECT/CT imaging before breast puncture and surgery. All subjects had pathological results, and estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2(HER-2), Ki-67 and microvessel density (MVD) were obtained by immunohistochemistry and fluorescence in situ hybridization (FISH). Two-sample t test and Kruskal-Wallis H test were used to analyze the data. Results Invasive ductal carcinoma was pathologically confirmed in 35 of 45 patients. There were 7 patients in stage Ⅰ, 11 patients in stage ⅡA and 17 patients in stage ⅡB. The Luminal A subtype, Luminal B subtype, ERBB2+ subtype, Basal-like subtype were found in 6, 9, 9 and 11 patients, respectively. The T/NT ratio was significantly higher in the stage Ⅱ B patients than that in stage Ⅰ+ ⅡA patients (4.54±1.46 vs 3.32±1.72, t=-2.24, P<0.05). Patients with ERBB2+ subtype had higher T/NT ratio compared to patients with Basal-like subtype: 5.80(3.90, 6.70) vs 2.80(2.20, 3.50), H=11.06, χ^2=15.31, both P<0.05. Besides, the T/NT ratios in the HER-2 positive group and lymphatic metastasis group were significantly higher than those in the HER-2 negative group and group without lymph node metastasis (t values: -3.99, -2.51, both P<0.05). MVD of HER-2 positive group was higher than that of HER-2 negative group (t=7.13, P<0.01). Conclusion The T/NT ratio during ^99Tc^m-3PRGD2 SPECT/CT imaging has relations with TNM staging, lymph node infiltration and HER-2 in breast cancer.

关 键 词：乳腺肿瘤 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 精氨酸-甘氨酸-天冬氨酸 

分 类 号：R737.9[医药卫生—肿瘤]