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^99Tc^m-MIBI显像评价乳腺癌新辅助化疗疗效 预览 被引量:9

^99Tc^m-MIBI imaging in the assessment of response to neoadjuvant chemotherapy in breast cancer
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摘要 目的 探讨^99Tc^m-甲氧基异丁基异腈(MIBI)显像评价乳腺癌新辅助化疗(NCT)疗效的价值。方法 35例局部进展期乳腺癌(LABC)患者术前化疗前后分别触诊估测肿瘤最大垂直长径及行^99Tc^m-MIBI显像,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。观察注射^99Tc^m-MIBI后60min显像图。采用目测法和半定量法,以病灶/本底(T/N)放射性比值降低〉35%为有效。临床疗效按WHO标准评价。化疗后肿瘤细胞病理形态学改变以Ⅱ、Ⅲ级定为显效,Ⅰ级定为弱效。结果 病理检查显效与弱效组间,显像目测法分析NCT有效率分别为75%和9%,差异有显著性(P〈0.01),灵敏度、特异性和准确性分别为75%、91%和80%;半定量法评价NCT疗效的灵敏度、特异性和准确性分别为84%、80%和83%;临床测量肿瘤最大垂直长径则分别为50%、64%和54%。^99Tc^m-MIBI显像评价疗效的灵敏度、准确性明显高于临床确诊。24例病理检查示显效的患者中,^99Tc^m-MIBI摄取与PCNA水平相关,与P-gP水平无关。结论 ^99Tc^m-MIBI显像可有效监测LABC患者术前NCT疗效。 Objective To evaluate the value of ^99Tc^m-methoxyisobutylisonitrile (MIBI) imaging in assessing response of breast cancer to neoadjuvant chemotherapy(NCT). Methods Thirty-five local advanced breast cancer (LABC) patients underwent clinical examination( measuring the largest tumor diameter) and 99Tcm-MIBI imaging before and after 3 cycles of CEF or CMF or CTF chemotherapy. The pathology was reviewed and immunostaining of P-glycoprotein (P-gp), proliferating cell nuclear antigen (PCNA) ex- pression were obtained after surgery. Visual analysis was used and tumor/normal tissue (T/N) ratio calculation 〉 35% was considered as effective response. Clinical response was based on WHO creteria. The pathological effect after chemotherapy at Ⅱ or Ⅲ grade was defined as markedly effective, the Ⅰ grade as weakly effective. Results The positive rate of imaging in the patients with markedly pathological effect (75%) was significantly higher than that in the patients with weakly effect (9%). The sensitivity, specificity and accuracy were 75%, 91% and 80% respectively for ^99Tc^m-MIBI imaging with visual analysis, while 84%, 80% and 83% respectively for semiquantitative analysis, 50%, 64% and 54% respectively for clinical examination.The senstivity and accuracy of the imaging were significantly higher than those of the clinical evaluation(P〈0.05),In the 24 patients with marked pathological effect.^99Tc^m-MIBI optake and TCNA level were correlated.bot no relationship with P-gp level was found.Conclusion ^99Tc^m-MIBI imaging can effectively monitor the neoadjuvant chemotherapy effect in LABC.
作者 关晏星 雷秋模 翟伟 杨晓青 熊秋云 朱传明 吴晓波 王莉 张青 张庆 曹亚丽 武彪 欧阳军 熊立跃 GUAN Yan-xing , LEI Qiu-mo, Qu Wei, et al. (Department of Nuclear Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang 330006, China)
出处 《中华核医学杂志》 CAS 北大核心 2006年第1期 36-38,共3页 Chinese Journal of Nuclear Medicine
基金 江西省科技厅计划资助项目(200110300102)
关键词 乳房肿瘤 放射性核素显像 MIBI 化学疗法 辅助 Mimmary neoplasms Radionuclide imaging MIBI Chemotherapy,adjuvant
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参考文献8

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