乳腺特异性伽马成像半定量指标与乳腺癌临床特征的相关性

Correlation between semi-quantitative index in breast specific gamma imaging and clinical features in patients with breast cancer

目的:探讨乳腺特异性伽马成像(BSGI)半定量分析指标与乳腺癌常见临床特征的相关性。方法:收集2016年1月至2017年7月在复旦大学附属中山医院住院的668例乳腺疾病患者。BSGI检查基于目测分析法和半定量分析法。其中,半定量分析的具体方法为:首先计算可疑病灶与邻近正常组织放射度的比值(T/N),分别在轴位(craniocaudal,CC)与内外侧斜位(mediolateral oblique,MLO)中各获取1个T/N值,选取最大值为半定量分析结果。比较不同病理状态下T/N值的差异。结果:668例患者中,恶性肿瘤患者505例、良性肿瘤患者163例,均可获得T/N值。受试者工作特征曲线(receiver operating characteristic curve,ROC)显示,临界T/N=1.81,AUC为0.83(SD=0.844,95%CI 0.812~0.872),BSGI敏感性为84.53%、特异性为74.02%。不同肿瘤大小(P=0.000)、Ki-67水平(P=0.039)、腋窝淋巴结转移情况(P=0.02)患者T/N值差异有统计学意义。结论:T/N值与肿瘤大小、Ki-67和腋窝淋巴结转移等临床病理因素相关,可用于预测乳腺癌的侵袭性,有助于医师进行临床决策。

Objective:To analyze the correlations of semi-quantitative index,tumor to non-lesion ratio(T/N)in breast specific gamma imaging(BSGI)and clinical features in breast cancer.Methods:Totally 668 patients who underwent BSGI from January 2016 to July 2017 were enrolled.BSGI interpretation was assessed based on visual spectrum analysis and semi-quantitative analysis.The value of T/N in craniocaudal(CC)and mediolateral oblique(MLO)view was respectively obtained and the maximum value was selected for semi-quantitative analysis.Then the T/N value was compared among different pathological status.Results:Among 668 cases,there were 505 of malignant mass and 163 of benign mass,and the T/N value was obtained in all the cases.Analysis of receiver operating characteristic curve(ROC)showed that the sensitivity and specificity in diagnosing breast cancer was 84.53%and 74.02%,respectively,taking critical value of T/N as 1.81,and the AUC was 0.83(SD=0.844,95%CI 0.812-0.872).The T/N value was significantly different among patients with different tumor size(P=0.000),Ki-67 expression(P=0.039)and axillary lymph node metastases(P=0.02).Conclusions:The T/N value in BSGI is correlated with tumor size,Ki-67 expression,and axillary lymph node metastases,which can be used in predicting aggressiveness of breast cancer.