^(99)Tc^m-octreotide显像在乳腺癌诊断中的应用

Primary application of ^(99)Tc^m-octreotide imaging in the diagnosis of breast cancer

目的 探讨99Tcm 奥曲肽 (octreotide)显像对乳腺癌诊断的临床价值。方法 36例乳腺肿块患者 ,据手术及病理检查结果分为乳腺癌组 (19例 )和乳腺良性病变组 (17例 )。术前分次进行乳腺99Tcm octreotide及99Tcm 甲氧基异丁基异腈 (MIBI)显像 ,行定性及半定量 [放射性摄取比值 (UR)测定 ]分析。结果 99Tcm octreotide显像对乳腺癌诊断的灵敏度 (6 8 4 %)低于99Tcm MIBI (94 7%,P <0 0 5 ) ,特异性 (10 0 %)明显高于99Tcm MIBI(76 5 %,P <0 0 5 ) ,准确性 (83 3%)与99Tcm MIBI (86 1%)差异无显著性 (P >0 0 5 )。联合99Tcm octreotide与99Tcm MIBI显像特异性高 (10 0 %) ,但准确性(80 6 %)无明显变化 (P >0 0 5 )。结论 99Tcm octreotide显像对乳腺癌诊断特异性高 ,准确性与99Tcm MIBI显像无明显差别。

Objective To evaluate the clinical value of 99 Tc m-octreotide scintigraphy in the diagnosis of breast cancer. Methods 99 Tc m-octreotide and 99 Tc m-methoxyisobutylisonitrile (MIBI) imaging were performed on 36 patients with breast masses confirmed by pathology (19 patients with breast cancer and 17 benign lesions). The imaging was read as positive when focal radioactivity increased in the breast both on 99 Tc m-octreotide and 99 Tc m-MIBI imaging. The uptake ratios (UR) of lesion (L) to normal (N) were calculated after 99 Tc m-MIBI injection at 10～15 min and 99 Tc m-octreotide injection at different time points (5～10 min,60～90 min and 180 min). Results The sensitivity of 99 Tc m-octreotide imaging in the diagnosis of primary breast cancer was lower than that of 99 Tc m-MIBI (68.4% vs 94.7%,P <0.05),but the specificity was significantly higher (100% vs 76.5%, P <0.05),whereas the accuracy showed no significant difference between 99 Tc m-octreotide and 99 Tc m-MIBI (83.3% and 86.1%,respectively,P >0.05). Conclusion Comparing with 99 Tc m-MIBI 99 Tc m-octreotide imaging showed a higher specificity and the same accuracy in the diagnosis of breast cancer.