^(99)Tc^(m)-MIBI乳腺癌显像与Ki-67预测新辅助化疗疗效的价值

Value of ^(99)Tc^(m)-MIBI breast cancer imaging and Ki-67 in predicting the efficacy of neoadjuvant chemotherapy

目的探讨乳腺癌摄取^(99)Tc^(m)-甲氧异腈(MIBI)与Ki-67抗原表达的关系,并验证Ki-67预测新辅助化疗(NAC)疗效的价值。方法回顾性分析2018年1月至2020年3月于宁夏医科大学总医院就诊的47例乳腺癌患者NAC前后双时相^(99)Tc^(m)-MIBI SPECT/CT断层融合显像,分析T/N比值和肿瘤大小在治疗前后的变化及与Ki-67之间的关系。采用两样本t检验、直线相关性及χ^(2)检验分析数据。结果乳腺癌^(99)Tc^(m)-MIBI显像NAC前后20 min T/N比值、2 h T/N比值下降差异有统计意义(P<0.05),肿瘤NAC化疗前后最大径缩小差异有统计学意义(P<0.05);Ki-67高表达组与低表达组患者NAC后T/N比值下降和肿瘤缩小差异均有统计学意义(P<0.05);Ki-67的表达与20 min和2 h T/N比值有相关性(P<0.05)。结论Ki-67抗原表达和乳腺^(99)Tc^(m)-MIBI显像有助于了解肿瘤增殖,Ki-67抗原表达对NAC疗效有预测价值,可用于指导临床治疗。

Objective To investigate the relationship between the uptake of ^(99)Tc^(m)-methoxysonitrile(MIBI)in breast cancer and the expression of Ki-67 antigen,and to verify the value of Ki-67 in predicting the efficacy of neoadjuvant chemotherapy(NAC).Methods We retrospectively reviewed the bitemporal ^(99)Tc^(m)-MIBI SPECT/CT tomography-fusion imaging of 47 breast cancer patients visited General Hospital of Ningxia Medical University between January 2018 and March 2020 before and after NAC.We analyzed the changes in T/N ratio and tumor size before and after treatment and the relationship with Ki-67.Two samples t test,linear correlation,and χ^(2) test were used to analyze the data.Results There was a statistically significant difference in T/N ratio between 20 min and 2 h before and after NAC with ^(99)Tc^(m)-MIBI imaging of breast cancer(P<0.05).The difference in maximum diameter shrinkage before and after chemotherapy with tumor NAC was statistically significant(P<0.05).There were significant differences in T/N ratio decrease and tumor shrinkage after NAC between patients in the high-expression Ki-67 group and the low-expression group(P<0.05).Expression of Ki-67 correlated with T/N ratios at 20 min and 2 h(P<0.05).Conclusion Ki-67 antigen expression and breast ^(99)Tc^(m)-MIBI imaging are helpful to understand tumor proliferation.Ki-67 expression has predictive value for NAC efficacy and can be used to guide clinical treatment.