^(99m)Tc-奥曲肽和^(99m)Tc-MIBI显像在乳腺癌临床的应用价值

Clinical Application of ^(99m)Tc-Octreotide and ^(99m)Tc-MIBI Imaging in the Diagnosis of Breast Cancer

目的 探讨99mTc 奥曲肽和99mTc MIBI显像在乳腺癌中的应用价值。方法 对我院住院手术治疗的2 6例怀疑为乳腺癌的乳腺肿块患者术前行99mTc 奥曲肽和99mTc MIBI显像。以术后病理检查结果作为金标准 ,分析比较两种显像的灵敏度、特异性和准确性。结果 乳腺肿块99mTc 奥曲肽显像的灵敏度、特异性和准确性分别是94 .4 %、87.5 %和 92 .3% ,99mTc MIBI显像分别是 88.9%、75 .0 %和 84 .6 % ,两者相比特异性和准确性间差异有显著性意义 (P<0 .0 5 ,P<0 .0 1) ;对于腋窝淋巴结转移的探测 ,99mTc 奥曲肽显像的灵敏度、特异性和准确性分别是6 6 .7%、92 .9%和 80 .8% ,99mTc MIBI分别是 5 8.3%、85 .7%和 73.1% ,两者相比特异性的差异有显著性意义 (P<0 .0 1)。结论 乳腺癌99mTc 奥曲肽显像优于99mTc MIBI显像 ,术前99mTc 奥曲肽显像有助于乳腺癌手术方式的选择。

Objective To evaluate the value of 99mTc-Octreotide somatostatin receptor and 99mTc-MIBI imaging in the detection of breast cancer. Methods 99mTc-Octreotide and 99mTc-MIBI imaging were performed in 26 patients with breast masses before operation. The scintigraphy results were analysed compared with pathologic study.Results The sensitivity, specificity and accuracy of 99mTc-Octreotide scintigraphy for breast cancer were 94.4%, 87.5%and 92.3%respectively and those of 99mTc-MIBI were 88.9%, 75.0%and 84.6%respectively. Significant difference was found between 99mTc-Octreotide and 99mTc-MIBI in both of specificity and accuracy (P<0.05 and P<0.01). The sensitivity, specificity and accuracy of 99mTc-Octreotide scintigraphy in the detection of axillary lymph node involvement were 66.7%, 92.9%and 80.8%respectively. Those of 99mTc-MIBI were 58.3%, 85.7%and 73.1%respectively. The specificity showed significant difference between 99mTc-Octreotide and 99mTc-MIBI (P< 0.01).Conclusion 99mTc-Octreotide somatostatin receptor imaging may be superior to 99mTc-MIBI in the detection of primary breast cancer and axillary lymph node involvement, and 99mTc-Octreotide scintigraphy before operation is helpful in working out operative modality for patients.