^(99m)Tc-MIBI显像可预测乳腺癌新辅助化疗的反应性

～(99m)Tc-MIBI scintigraphy predict the neoadjuvant chemotherapy reaction in breast cancer

目的探讨根据乳腺99mTc-MIBI显像的表现,预测乳腺癌新辅助化疗反应性的临床价值。方法对43例Ⅱ、Ⅲ期的乳腺癌患者,手术前行乳腺癌99mTc-甲氧基异丁基异睛(99mTc-MIBI)早期显像和延迟显像。对显像阳性的肿块计算感兴趣区与对侧正常相应部位放射性计数比值,以早期摄取比值(EUR)和延迟摄取比值(DUR)计算滞留指数(RI),之后行2周期的FAC方案化疗。结果在99mTc-MIBI显像RI≥0组,化疗的有效率为83.3%(25/30),在RI<0组化疗的有效率23.1%(3/13),两组间差异有显著的统计学意义(P<0.01)。结论乳腺99mTc-MIBI显像可以预测新辅助化疗的反应性,指导个性化化疗方案的选择。

Objective To predict the effect of neoadjuvant chemotherapy for breast cancer by ^99mTc-MIBI scintimammography. Methods Forty-three patients with stage Ⅱ, Ⅲ breast cancer were enrolled in this study. Before operation, ^99mTc-MIBI scintigraphy was performed at 15 min and 90 min after injecting the tracer. The uptake of ^99mTc-MIBI was evaluated as tumor over background ratio with region of interest technique. Such indexes as early uptake ratio （EUR）, delay uptake ratio （DUR） and retention index （RI） were calculated respectively. Then two cycles of FAC [5-FU 500 mg/m^2 （1st day, 8th day）, ADM 30 mg/m^2 （1st day）, CTX 500 mg/m^2 （1st day, 8th day）, every 3 weeks] were administrated. Results In the group RI≥0, respone rate was 83.3 %（25/30）. In the group RI 〈 0, respone rate was 23.1%（3/13）. There was significant difference between the two groups （P 〈 0.01）. Conclusion It is suggested that ^99mTc-MIBI scintimammography can be used as predictor of response to neoadjuvant chemotherapy in breast cancer, and be beneficial to select individualized chemotherapy regimen.