^(99m)锝-甲氧基异丁基异腈显影预测乳腺癌新辅助化疗疗效的应用研究

^(99m)Tc-MIBI scintigraphy predict the neoadjuvant chemotherapy efficacy in breast cancer

目的探讨99m锝-甲氧基异丁基异腈(99mTc-MIBI)显像在预测乳腺癌新辅助化疗疗效的临床价值。方法 26例乳腺癌患者静脉注射99mTc-MIBI740MBq后于20-30min及120-180min分别行早期及延迟显像,计算早期摄取比值(T/Ne)、延迟摄取比值(T/Nd)及滞留率(RI%),随后行2个周期的PA方案化疗,对化疗有效组和化疗无效组的T/Ne、T/Nd及RI%进行比较;对RI%≥0组和RI%<0组的化疗有效率进行比较。结果化疗有效组与化疗无效组在T/Nd(t=2.186)和RI%(Z=-2.899)值上存在统计学差异(P<0.05),也就是说化疗有效组的T/Nd比值和RI%明显高于化疗无效组。RI%≥0组,化疗有效率为83.3%;而RI%<0组,化疗有效率为25.0%,两组间统计学有明显差异(P<0.05)。结论 99mTc-MIBI乳腺显像的摄取与滞留在乳腺癌新辅助化疗有效组与无效组差异显著,99mTc-MIBI显像可预测乳腺癌新辅助化疗疗效,能够为指导个体化化疗提供帮助。

Objective To predict the efficacy of neoadjuvant chemotherapy for breast cancer by 99mTc-MIBI Scintigraphy.Methods 26 patients with breast cancer were intravenously injected with 740MBq 99mTc-MIBI in the arm contralateral to the lesion.Anterior planar scintigraphy were acquired at 20-30min and 120-180min after injection.Such indexes as early uptake ratio,delay up-take ratio and retention index （ RI） were calculated respectively.In 26 patients underwent neoadjuvant chemotherapy,two cycles of PA administrated （ Paclitaxel 150mg/m2,1st day; Epirubicin 60mg/m2,2st day; every 3 weeks） .Results In the group RI≥0,response rate was 82.7% .In the group RI0,response rate was 25.0% .There was significant difference between the two groups （ P0.05） .Conclusions It is suggested that 99mTc-MIBI scintigraphy can be used as predictor of efficacy to neoadjuvant chemotherapy in breast cancer,and be beneficial to select individualized chemotherapy regimen.