^(18)F-FDG PET/CT诊断乳腺癌及腋窝淋巴结转移的价值

Value of ^(18)F-FDG PET/CT in the diagnosis of breast cancer and axillary lymph node metastasis

目的探讨^(18)F-脱氧葡萄糖(^(18)F-FDG)正电子发射断层扫描(PET/CT)诊断乳腺癌和腋窝淋巴结(ALN)转移的价值。方法选取2015年7月至2016年4月间海南省人民医院收治的79例拟诊断为乳腺癌的患者,均采用^(18)F-FDG PET/CT、超声检查和钼靶X线检查。比较三种不同方式的诊断结果,对比分析^(18)F-FDG PET/CT检查结果和术后病理结果,讨论^(18)F-FDG PET/CT诊断乳腺癌和ALN转移的价值。结果术后病理结果显示,所有疑为乳腺癌的患者均确诊为乳腺癌。^(18)F-FDG PET/CT检查结果为阳性64例,阴性15例,灵敏度为81.0%;超声检查结果为阳性47例,阴性32例,灵敏度为59.5%;钼靶X线检查结果为阳性53例,阴性26例,灵敏度为67.1%,^(18)F-FDG PET/CT检查灵敏度明显高于超声检查和钼靶X线,差异均有统计学意义(P<0.05)。^(18)F-FDG PET/CT诊断ALN转移的灵敏度为35.0%,准确度为70.9%,特异度为83.1%,阴性预测值为79.0%,阳性预测值为41.2%。结论^(18)F-FDG PET/CT对乳腺癌的诊断的灵敏度明显优于超声检查和钼靶X线检查,诊断ALN转移有较好的特异度和准确度。

Objective To explore the value of fluorine-18 fluorodeoxyglucose（^18F-FDG） positron emission tomography（ PET） and computerized tomography（ CT） in the diagnosis of breast cancer and axillary lymph node（ ALN） metastasis. Methods Seventy-nine patients of suspected breast cancer treated at Hainan General Hospital were selected from July 2015 to April 2016. All the patients were examined by18 FFDG PET/CT,ultrasonography and molybdenum target X-ray. The diagnostic results of the three different diagnosis methods were compared. The result of^18F-FDG PET/CT examination and postoperative pathological result were compared and analyzed. and the value of^18F-FDG PET/CT in the diagnosis of breast cancer and ALN metastasis was discussed. Results Postoperative pathological results showed that all suspected breast cancer patients were diagnosed with breast cancer.^18F-FDG PET/CT examination showed that positive results were noted in 64 patients and negative results were noted in 15 patients and the sensitivity rate was 81. 0%. Ultrasonography examination showed that positive results were noted in 47 patients and negative results were noted in 32 patients and the sensitivity rate was 59. 5%. Molybdenum target X-ray examination showed that positive results were noted in 53 patients and negative results were noted in 26 patients and the sensitivity was 67. 1%. The sensitivity of^18F-FDG PET/CT examination was significantly higher than that of ultrasonography and molybdenum target X-ray examination（ P〈0. 05）. Based on the maximum standardized uptake value of ≥ 1. 5 to judge ALN metastasis,sensitivity was 35. 0%,accuracy was70. 9%,specificity was 83. 1%,and negative predictive value is 79. 0% and the positive predictive value was 41. 2% for^18F-FDG PET/CT. Conclusion The sensitivity of^18F-FDG PET/CT in the diagnosis of breast cancer is better than ultrasonography and molybdenum target X-ray examination with good specificity and accuracy.