^(99m)Tc-MDP骨显像联合CT对乳腺癌术后早期随访的临床价值

Clinical value of combining CT and ^(99m)Tc-MDP bone scan in the postoperative follow-up of the breast cancer

目的^(99m)Tc-MDP骨显像联合CT对乳腺癌术后早期随访,监测其复发及转移的临床应用价值。方法81例乳腺癌手术化疗后3年内的病人,女性,年龄29～65岁,分别行^(99m)Tc-MDP骨显像、CT显像、计算灵敏度、特异性、准确性。结果81例乳腺癌手术化疗后病人中,经病理检查或临床及其他影像学诊断转移的31例,99mTc-MDP骨显像诊断骨转移的15例,CT显像诊断复发及转移的病例18例,^(99m)Tc-MDP骨显像对骨转移的灵敏度、特异性、准确性分别为93.8%、90.8%、91.4%,CT显像对复发及转移的灵敏度、特异性、准确性分别为58.1%、88.0%、93.8%、90.8%、91.4%,其对骨转移的灵敏度、特异性、准确性分别为51.2%、91.0%、88.4%。CT联合^(99m)Tc-MDP骨显像诊断复发及转移的灵敏度、特异性、准确性分别为94.3%、90.6%、93.3%。结论CT对乳腺癌术后病人软组织的复发及转移有较高的灵敏度,但对于骨转移病灶不及^(99m)Tc-MDP骨显像敏感。因此,两者联合应用可明显提高乳腺癌术后复发及转移的灵敏度、特异性和准确性,对监测其复发及转移具有重要的临床应用价值。

Objeelive To evaluate the value of clinical application of the combination of CT and ^99mTc-MDPbone scan in the follow - up monitoring of cancer recurrences of the breast cancer patients previously treated with both mastecomy and chenotherapy. Methods 81 female breast cancer patients between the ages of 29 and 65 years treated with nutstectomy and chemotherapy within the past three years were enrolled in this study. All of them underwent CT^99mTc-MDP bone scan. The calculation of the sensitivity, specialty, accuracy, were analyzed. Results In these 81 breast cancer patients, 31 patients who have cancer recurrences （local, regional and distant recurrences） were detected by ^99mTc-MDP, 18 patients who have cancer recurrences were found by CF. The sensitivity, specialty, accuracy of ^99mTc-MDP bone scan in determining osseuous metastasis were 93.8 %, 90.8 %,91. 4% respectively; while they were 51.2% ,91.0% ,88.4% respectively in CT scan; when combining ^99mTc-MDP bone scan with CT scan , they were 94. 3 %, 90.6%, 93.3 % respectively. Conclusion It is obvious that the studies demonstrate a trend towards greater sensitivity of CT for the diagnosis of the breast cancer recurrences of patients after surgery and chemotherapy. But it shows a lower sensitivity, compared to the use of ^99mTc-MDP bone scan in the detection of osseous metastasis. In conclusion, the combination of CT and ^99mTc-MDP in the follow - up studies of the breast cancer patients previously treated with both mastectomy and chemotherapy can obtain the higher sensitivity , specialty and accuracy, making a significant contribution to the value of clinical application.