摘要
目的探讨18F-氟代脱氧葡萄糖(18F-FDG)符合线路PET/CT联合钼靶、B超在乳腺癌诊断中的临床应用价值。方法回顾性分析36例乳腺癌手术后患者,根据病灶大小分为3组(<1.0 cm组,1.0~2.0 cm组,>2.0 cm组),术前均进行B超、钼靶X线乳腺摄影和符合线路正电子发射计算机断层显像(PET)/CT检查。结合术后病理,比较符合线路PET/CT、B超、钼靶X线乳腺摄影诊断乳腺癌的结果。结果 6例肿瘤直径<1 cm中,18F-FDG符合线路PET/CT未发现病灶,钼靶诊断4例,B超诊断2例。19例1.0~2.0 cm患者中,符合线路PET/CT、B超、钼靶X线、三者联合敏感性分别为:52.61%、78.95%)、47.37%、94.74%,B超、钼靶与联合检查的敏感性差异无统计学意义(χ2=1.12,P>0.05);B超、钼靶与PET/CT比较差异无统计学意义(χ2=4.94,P<0.05)。病灶直径>2.0 cm,检查敏感性分别为钼靶81.82%、B超90.91%、PET/CT 90.91%、联合检查100%;3种检查与联合检查的检出率差异无统计学意义。在判断腋窝淋巴结转移中,各种检查的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为18F-FDG符合线路PET/CT 86.67%,80.95%,83.33%,76.47%,89.47%,B超66.67%,61.90%,63.89%,55.56%,72.22%,钼靶20.0%,90.48%,61.11%,60.0%,61.29%。结论乳腺肿瘤直径<2.0 cm时,B超结合钼靶的敏感性较18F-FDG符合线路PET/CT高,且经济适用;当肿瘤>2.0 cm时,三者敏感性相近。乳腺癌不同病理分型中对18F-FDG摄取不尽相同。在淋巴结转移及临床分期上,18F-FDG符合线路PET/CT有明显优势。
Objective To explore the clinical value of18F-fluorodeoxyglucose（18F-FDG） PET/CT in combination of mammography and ultrasound in diagnosing breast cancer. Methods A retrospective analysis of 36 patients with breast cancer after surgery was performed. The patients were divided into 3 groups（〈1.0 cm, 1.0-2.0 cm and 〉2.0cm）. They had undergone preoperative ultrasound, molybdenum target X-ray mammography and PET/CT. We compared the diagnostic performance of these modalities. Results In the 6 patients with 〈1.0 cm tumor size,18F-FDG PET/CT failed in all cases, while mammography and ultrasound detected the lesions in 4 and 2 cases, respectively. In the 19 patients with 1.0-2.0 cm tumor size, sensitivity of the PET/CT, ultrasound, mammography, alone and combina-tion of the three was 52.61%）, 78.95%, 47.37% and 94.74%, respectively. There was no difference among the sen-sitivity of ultrasound, mammography and combined detection, while the PET/CT differed from the ultrasound and mam-mography in detection sensitivity（ χ2=4.94, P 〈0.05）. For the cases with 〉2.0 cm tumor size, the sensitivity was81.82% with the X-ray mammography, 90.91% with the ultrasound, 90.91% with the PET/CT, and the 100% with combination of the three. In judgment of axillary lymph node metastasis of the breast cancer, the sensitivity, specifici-ty, accuracy, positive predictive value and negative predictive value were as follows： PET/CT（86.67%, 80.95%,83.33%, 76.47%, 89.47%）, ultrasound（66.67%, 61.90%, 63.89%, 55.56%, 72.22%）, and molybde-num target（20.0%,90.48%, 61.11%, 60.0%, 61.29%）. Conclusion In diagnosis of 〈2 cm breast cancer, ultra-sound combined with mammography is more sensitive and affordable than PET/CT. When the tumor is greater than 2 cm, the three diag-nostic modalities offer similar sensitivity. Breast cancer of different pathological types show differ-ent18F-FDG uptake.PET/CT appears to have evident advantages which justify it as reference for clinical purpose.
出处
《中国药物与临床》
CAS
2015年第3期323-327,共5页
Chinese Remedies & Clinics
基金
杭州市科技发展计划项目(20120633B37)
