99mTc-MIBI乳腺显像评价乳腺癌新辅助化疗疗效的临床价值

目的 探讨99mTc -MIBI显像评价乳腺癌新辅助化疗（NACT）疗效的临床价值。方法50例局部进展期乳腺癌（LABC）患者在术前化疗前后分别行临床触诊估测肿瘤大小、B超、钼靶及99mTc-MIBI显像，术后对乳腺癌标本行病理检查及P-糖蛋白（P-gP）、增殖细胞核抗原（PCNA）免疫组织化学染色。以99mTc-MIBI早期相反应率STR〉50%为有效标准。临床疗效按WHO标准评价。化疗后肿瘤细胞病理形态学改变以Ⅱ、Ⅲ级为显效，I级为弱效。结果 病理检查显效与弱效组间，99mTc-MIBI显像评价NCT疗效的灵敏度、特异性和准确性均高于临床扪诊及钼靶，与B超检查相似。99mTc-MIBI摄取与PCNA水平相关，而与治疗后P-gP水平无关。结论 99mTc-MIBI显像可有效评价LABC患者术前NCT疗效。

Clinical value of ^99mTc-MIBI breast imaging in the assessment of neoadjuvant chemotherapy for breast cancer

Objective： To discuss the clinical value of 99mTe-MIBI image on neoadjuvant chemotherapy for breast cancer（NCT）. Methods： Fifty cases of locally advanced breast cancer（LABC） without surgery were palpated to measuring the largest tumor diameter, examined by Color Doppler Ultrasonography, Mammography and 99m Te- MIBI imaging before and after chemotherapy. Pathological examination and immunostaining of P- glycoprotein （ p- gp）, proliferating ceil nuclear antigen （PCNA） expression were carried out after surgery. In early 99mTe- MIBI phase, scintigraphic tumor response（STR） 〉 50% was as effective standard. The clinical efficacy was be evaluated by WHO standard. The I grade was defined as weakly effective and the II or III grade pathological changes after chemotherapy were defined as markedly effective. Results： The pathological examination as the standard, the sensitivity, specificity and accuracy of 99mTc-MIBI imaging to evaluating the effect of NCT were higher than clinical palpation and Mammography,and was similar with Color Doppler Ultrasonography. The intake of 99mTc-MIBI were correlated with PCNA level, but without P-gP level of after treatment. Conclusion： 99mTc-MIBI imaging can be effectively to evaluate the effectiveness of NCT for LABC patients before operation.