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目的:探讨99mTc-MIBI显像评价乳腺癌新辅助化疗(NCT)疗效及预后的临床价值。方法:57例乳腺癌患者NCT前及2个周期(30例)、3个周期(57例)NCT后分别行乳腺99mTc-MIBI显像。肿瘤部位摄取采用靶和非靶比值(T/N)表示,术后行乳腺癌病理化疗反应分析。以NCT后T/N比值降低百分率>30%为判断化疗有效的阈值,将结果与病理检查结果对比,评价其诊断效能。根据该判断阈将患者分为显像有效组和无效组,进行临床随访,分析两组无进展生存时间(PFS)。结果:2个周期NCT后,99mTc-MIBI显像评价疗效的灵敏度、特异性和准确性分别为89%、83%和86%,阴性和阳性预测值分别为88%和83%,与对3个周期NCT疗效评价的效能差异无统计学意义,P>0.05。显像示有效组平均PFS为46.93个月,显像示无效组平均PFS为35.76个月,两组差异有统计学意义,P<0.05。结论:99mTc-MIBI显像对评价乳腺癌NCT反应、估计预后具有临床应用价值。
Objective: To investigate the clinical value of 99mTc-MIBI imaging in assessing the efficacy and prognosis of breast neoadjuvant chemotherapy (NCT). Methods: Breast 99mTc-MIBI imaging was performed in 57 breast cancer patients before NCT, 2 cycles (30 cases) and 3 cycles (57 cases) after NCT. The uptake of the tumor site was expressed as the ratio of target to non-target (T / N), and postoperative pathological chemotherapy response analysis of breast cancer. To reduce the T / N ratio of NCT after the percentage of> 30% to determine the effective threshold for chemotherapy, the results of pathological examination results compared to evaluate the diagnostic efficacy. According to the judgment threshold, the patients were divided into two groups: imaging effective group and ineffective group. The patients were followed up and the PFS was analyzed. Results: After 2 cycles of NCT, the sensitivity, specificity and accuracy of 99mTc-MIBI imaging were 89%, 83% and 86%, respectively. The negative and positive predictive values were 88% and 83% There was no significant difference in the efficacy of NCT for every cycle, P> 0.05. The average PFS of the effective group was 46.93 months, and the average PFS of the ineffective group was 35.76 months. There was significant difference between the two groups (P <0.05). Conclusion: 99mTc-MIBI imaging in evaluating breast cancer NCT response, prognosis has clinical value.