乳腺专用伽马显像中99Tcm-甲氧基异丁基异腈的摄取与乳腺浸润性导管癌患者临床病理特征的关系

Correlation of 99Tcm-methoxyisobutylisonitrile uptake on breast-specific gamma imaging with clinicopathological characteristics of invasive breast ductal carcinoma patients

目的分析乳腺浸润性导管癌患者的临床病理特征与乳腺专用伽玛显像(BSGI)中99Tcm-甲氧基异丁基异腈(MIBI)摄取之间的关系。方法回顾性分析2014年3月至2018年3月就诊于威海市立医院行BSGI检查、未接受新辅助治疗及穿刺活组织检查及术前无肿瘤远处转移的浸润性导管癌患者244例的临床资料。分析患者的BSGI数据,计算病灶的放射性计数与正常组织的比值(T/N),从而评估肿瘤对99Tcm-MIBI的摄取量。T/N为偏态分布数据,用M(P25~P75)表示。用Wilcoxon秩和检验分析患者临床病理特征与T/N之间的关系,用多元线性回归模型分析患者临床病理特征对T/N的影响。结果全部244例患者BSGI中的T/N范围为1.0~7.5。Wilcoxon秩和检验结果显示T/N与T分期、N分期、组织学分级及Ki67表达有关(Z=-6.852、5.198、-3.931,P均<0.001;Z=-3.059,P=0.002),而与ER、PR、HER-2、P53、EGFR表达及三阴性乳腺癌无关(Z=-0.730、-1.526、-1.137、-1.175、-1.224、-1.556,P均>0.050)。多元线性回归分析表明T分期及N分期是T/N的影响因素(t=5.100,95%CI:0.414~0.935,P<0.001;t=2.819,95%CI:0.118~0.668,P=0.005)。结论乳腺浸润性导管癌的T分期和N分期可能影响BSGI中肿瘤对99Tcm-MIBI的摄取,因此,可以通过术前测定BSGI的T/N,对肿瘤的恶性程度进行初步评估。

Objective To analyze the relationship between the clinicopathological characteristics of invasive breast ductal carcinoma patients and the uptake of 99Tcm-methoxyisobutylisonitrile (MIBI) on breast-specific gamma imaging (BSGI).Methods We retrospectively analyzed the clinical data of 244 patients with invasive breast ductal carcinoma who underwent BSGI in the Weihai Municipal Hospital from March 2014 to March 2018, with no neoadjuvant therapy and biopsy and no distant metastasis before surgery. The BSGI data of all patients were analyzed, and the ratio of radioactive count in tumor to radioactive count in normal tissue (T/N) was calculated to assess the uptake of 99Tcm-MIBI in tumor. With skewed distribution, T/N was expressed as M(P25-P75). Wilcoxon rank sum test was used to analyze the relationship between the clinicopathological characteristics and T/N, and the multiple linear regression model was used to analyze the effect of clinicopathological characteristics on T/N.Results In all 244 patients, T/N on BSGI ranged from 1.0 to 7.5. The results of Wilcoxon rank sum test showed that T/N was correlated with T stage, N stage, histological grade and Ki67 expression (Z=-6.852, 5.198, -3.931, P<0.001;Z=-3.059, P=0.002), but not correlated with ER, PR, HER-2, P53, EGFR expression and triple negative breast cancer (Z=-0.730, -1.526, -1.137, -1.175, -1.224, -1.556, P>0.050). The multiple linear regression analysis showed that T stage and N stage were influencing factors of T/N (t= 5.100, 95%CI: 0.414-0.935, P<0.001;t=2.819, 95%CI: 0.118-0.668, P=0.005).Conclusions The T stage and N stage of invasive breast ductal carcinoma may affect the uptake of 99Tcm-MIBI on BSGI. Therefore, using BSGI, T/N can be measured preoperatively to evaluate the malignancy of tumors.