^(18)F-FDG PET/CT在166例乳腺癌术后诊断中的应用价值

Value of FDG- PET/CT in the evaluation of local recurrence,metastasis and multiple primary malignant neoplasms after breast cancer resection

目的:研究18F-FDG PET/CT在乳腺癌术后胸壁复发,区域淋巴结转移,远处转移,术后伴发多原发恶性肿瘤评价中的临床应用价值。方法:自2007年3月至2013年5月,临床疑乳腺癌术后复发转移患者166例(女164例,男2例,其中同步双乳癌3例,年龄22~80岁,平均45.2岁),行全身18F-脱氧葡萄糖(18F-FDG)PET/CT显像,术后检查时间间隔3天-10年,平均2.6年。分别以外科手术病理结果和/或临床放化疗后随访结果为依据,建立最后诊断,随访时间大于12个月。结果:166例患者中,诊断乳腺癌术后胸壁复发,区域淋巴结转移及远处转移110例(66.3%)。术区胸壁复发18例(10.8%),区域淋巴结转移68例(40.9%)。远处转移61例(36.7%),其中术区胸壁复发、区域淋巴结转移合并远处转移37例(22.3%)。乳腺癌术后伴发多原发恶性肿瘤22例(13.3%),其中包括异步对侧乳腺癌7例(4.2%)。51例(31.5%)患者PET/CT检查后更改完善了治疗方案。结论:全身18F-FDG PET/CT检查对乳腺癌术后胸壁复发、区域转移淋巴结、远处转移及术后伴发多原发恶性肿瘤诊断有重要临床应用价值,可为进一步治疗决策提供依据。

Objective To assess the clinical usefulness of FDG PET/CT in evaluation of local recurrence, metastasis and multiple primary malignant neoplasms after breast cancer resection. Methods A retrospective analysis of 166 patients with suspicious recurrence or metastases after breast cancer resection during the period 2007 - 2013 was performed. All of the patients underwent FDG PET/CT examination for suspicious recurrence or metastases after breast cancer resection. The standard of reference for final diagnosis consisted of histopathologic confirmation or clinical follow - up information for at least 12 months after PET/CT examinations. Results 110 of the 166 patients （66. 3% ） were found to have a recurrence or metastatic lesion. 18 patients （ 10. 8% ） were local recurrences. 68 patients （40. 9% ） were local lymph node metastases. 61 patients （40. 9% ） were distant metastases. 37 patients （22. 3% ） with local recur- rences or local lymph node metastases combined with distant metastases. Multiple primary malignant neoplasms were detected in 22 pa- tients （ 13. 3% ）, including 7 patients with contralateral breast cancer. Clinical treatment plans were changed in 51 （31.5%） patients after PET/CT examination. Conclusions The whole body FDG PET/CT may play an important role in evaluating of local recurrence, metastasis and multiple primary malignant neoplasms after breast cancer resection.