99mTc-MIBI乳腺显像与乳腺X线照相在乳腺癌诊断中的价值

目的评价^99m Tc-MIBI乳腺显像与乳腺X线照相检测乳腺癌的实用性。方法对100例106个经临床检查可疑乳腺病灶的妇女进行乳腺钼靶X线照相和^99m Tc-MIBI乳腺显像检查,并与病理学诊断结果进行对比。结果与病理组织学诊断比较,钼靶照相检测乳腺癌特异性为44．6％,阳性预测值为31．7％;^99m Tc-MIBI显像检测乳腺癌的特异性为87．8％,阳性预测值为76．9％。结论^99m Tc--MIBI乳腺显像对乳腺癌的诊断较乳腺X线照相具有较大的临床价值。     

99mTc-MIBI乳腺显像与乳腺X线照相对乳腺肿瘤的诊断价值

我们选用99mTc MIBI(甲氧基异丁基异腈)和乳腺钼靶X线照相对10 0例经临床检查可疑乳腺病变的妇女进行影像学检测,以提高乳腺肿瘤的诊断率,现报告如下。资料与方法1.一般资料:研究对象:哈尔滨医科大学附属第二医院乳腺科1998年至2 0 0 2年对10 0例经临床检查可疑乳腺病变的妇女进行了乳腺钼靶X线照相和99mTc MIBI乳腺显像,平均年龄(4 8 3±10 8)岁,79例临床可触及肿块,大小为0 8～10 0cm ,≤2 0cm者5 8例,2 1例未触及肿块而腺体局限性硬韧。所有患者均行手术治疗,并经病理学诊断。2 .检查方法:乳腺显像是在乳腺病变对侧前臂静脉“弹…     

乳腺肿物~(99m)Tc甲氧基异丁基异腈显像的临床价值

目的　评价99mTc甲氧基异丁基异腈 (MIBI)乳腺显像对乳腺癌诊断的价值。方法　对 195例 2 0 4处乳腺肿物患者分 3组进行99mTc MIBI显像 ,并与病理对照 ,另选择无乳腺疾病者 2 0例作对照组。99mTc MIBI在乳腺中有异常浓聚且阈值数大于健侧相对应区 10 %时为阳性。结果　本研究中乳腺癌病变 10 0处 ,阳性显像 92处 ;乳腺良性病变 70处 ,阳性显像 12处 ;隐匿性病变 34处 ,阳性显像 6处 ,3处为乳腺癌 ;对照组 2 0例显像均阴性。99mTc MIBI对乳腺疾病的诊断准确率为 92 0 %、灵敏度为 91 8%、特异度为 92 %、阳性预测值为 86 %、阴性预测值为 92 %。结论　 99mTc MIBI对乳腺癌的诊断及良恶性病变的鉴别有较高的敏感性和准确性。     

乳腺肿物99mTc甲氧基异丁基异腈显像的临床价值

目的 评价^99mTc甲氧基异丁基异腈（MIBI）乳腺显像对乳腺癌诊断的价值。方法 对195例和204处乳腺肿物患者分3组进行^99mTc－MIBI显像,并与病理对照,另选择无乳腺疾病者20例作对照组。^99mTc－MIBI在乳腺中有异常浓聚且阈值数大于健侧相对应区10％时为阳性。结果 本研究中乳腺癌病变100处,阳性显像92处;乳腺良性病变70处,阳性显像12处;隐匿性病变34处,阳性显像6处,3处为乳腺癌;对照组20例显像均阴性。^99mTc－MIBI对乳腺疾病的诊断准确率为92．0％,灵敏度为91．8％、特异度为92％、阳性预测值为86％、阴性预测值为92％。结论 ^99mTc－MIBI对乳腺癌的诊断及良恶性病变的鉴别有较高的敏感性和准确性。     

~(99m)Tc-甲氧基异丁基异腈显像诊断乳房肿块的临床价值

目的　评价99mTc 甲氧基异丁基异腈 (MIBI)显像鉴别乳房肿块良恶性的价值。方法　对 10 6例乳房肿块行99mTc MIBI显像检查 ,全部病例均经手术治疗 ,与病理结果比较。结果　 10 6例中乳腺癌 5 6例 ,显像阳性 48例 ,假阴性主要为肿块较小的乳腺癌 ;良性病变 5 0例 ,显像阴性 40例 ,假阳性主要为血供丰富的大纤维腺瘤。该法诊断乳腺癌的灵敏度为 85 7%、特异性为 80 0 %、阳性预告值 82 8%、阴性预告值 83 3 %、总正确诊断率为 83 0 %。结论　99mTc MIBI显像是鉴别乳房良恶性肿块的有效的、无创性检查方法 ,但对大纤维腺瘤和较小的恶性肿块诊断作用较差。     

乳腺肿块Sono CT高频超声显像与钼靶X线诊断对照研究

目的 分析比较Sono CT高频超声显像与钼靶X线摄影法对乳腺肿块的临床诊断价值。方法 193例乳腺肿块患者，其中乳腺癌58例，良性肿块135例，在术前1周内同时行Sono CT高频超声显像和钼靶X线摄影检查。结果 超声诊断早期乳腺癌46例，其敏感性79．31％，特异性94．81％，准确性90．16％。钼靶诊断早期乳腺癌47例，其敏感性和特异性为81．03％和89．63％，准确性为87．05％。超声对于良性肿瘤分类诊断的敏感性、特异性和准确性均高于钼靶。结论 Sono CT高频超声与钼靶X线摄影比较，发现前者对早期乳腺癌的敏感性和阴性预测值近于后者，特异性和阳性预测值则高于后者，而对于良性肿瘤的分类诊断前者优于后者。     

钼靶X线对乳腺良恶性病变诊断的临床意义

目的 评价钼靶X线检查对乳腺良恶性病变诊断的临床意义.方法 对100例临床可触及乳腺肿块患者进行钼靶X线检查,分析病变的X线征象,并与病理结果 进行对照.结果 100例患者中钼靶X线诊断为乳腺癌40例,良性病变60例.术后病理证实乳腺癌46例,良性病变54例.钼靶X线诊断正确率为87%.结论 乳腺钼靶X线检查是诊断和鉴别乳腺良恶性肿瘤首选有效的影像学方法.     

X线钼靶与B超对乳腺良恶性病变诊断的ROC曲线分析

目的:探讨X线钼靶与B超对乳腺良恶性病变诊断价值,加强乳腺癌的预防及提高对乳腺癌患者的早期诊断和治疗。方法:乳腺良恶性病变患者120例分别进行X线钼靶与B超检查,对诊断效果进行ROC曲线分析。结果:钼靶X线诊断的敏感性为96.8%,特异性为82.8%;B超诊断的敏感性与特异性为98.6%和98.0%。B超诊断的特异性高于X线诊断(P<0.05)。ROC曲线分析显示X线钼靶和B超用于乳腺良性病变诊断无显著统计学意义(P>0.05),对乳腺癌的诊断效果差异有统计学意义(P>0.05)。结论:钼靶X线难以显示致密腺体内的病灶,而B超不受干扰可进行多方位扫查的优点恰好弥补了钼靶X线的不足,使得其对于乳腺癌诊断的特异性加强。     

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

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。     

乳腺血氧功能成像系统在乳腺疾病诊断中的应用

目的探讨乳腺血氧功能成像系统(血氧三算子)在乳腺疾病诊断中的应用价值。方法 2010年3月～9月对120例乳腺疾病进行血氧三算子、超声和乳腺钼靶检查(患者≤35岁不接受钼靶检查),3项检查至少有一项提示有手术指征,通过与术后病理对比,比较3种影像学诊断的准确性、敏感性、特异性、阳性预测值及阴性预测值。结果血氧三算子与超声、乳腺钼靶的准确率分别为93.3%(112/120)、87.5%(105/120)、82.4%(70/85);敏感性分别为93.5%(29/31)、74.2%(23/31)、61.5%(16/26);特异性分别为93.2%(83/89)、92.1%(82/89)、91.5%(54/59);阳性预测值分别为82.9%(29/35)、76.7%(23/30)、76.2%(16/21);阴性预测值为97.6%(83/85)、91.1%(82/90)、84.4%(54/64)。血氧三算子对乳腺病灶诊断的准确性、敏感性、阴性预测值优于乳腺钼靶(Z=2.212,P=0.027;Z=2.623,P=0.009;Z=2.735,P=0.006),但二者特异性和阳性预测值无统计学差异(Z=0.066,P=0.948;Z=0.395,P=0.693)。结论血氧三算子对乳腺病灶诊断具有较高的准确性、敏感性、阴性预测值,对乳腺癌的诊断有较大应用价值。     

炎性乳腺癌

目的　探讨炎性乳腺癌的病理特点,诊断及治疗。方法　对７ 例病人的临床资料进行回顾性分析。结果　７ 例均手术治疗,１ 例行单纯乳腺切除术,６ 例行乳癌根治术。２ 例术前行化疗,５ 例术后行化疗及放疗。７ 例均在术后２ 年内死亡。结论　本病有其独特的临床表现及病理特点;诊断主要依靠临床表现及病理检查;治疗以综合治疗为佳。     

Role of technetium tetrofosmin scintimammography in the diagnosis of malignant breast masses and axillary lymph node involvement: a comparative study with mammography and histopathology.

OBJECTIVE: To assess the role of Technetium-99m (99mTc) tetrofosmin scintimammography in the detection of breast cancer and involvement of axillary nodes. DESIGN: Open study. SETTING: General hospital, Turkey. SUBJECTS: 128 women who presented with masses in the breast. INTERVENTIONS: Scintimammography, standard mammography, and either excision or fine-needle aspiration biopsy to confirm the diagnosis. MAIN OUTCOME MEASURES: Sensitivity, specificity, and positive and negative predictive value of scintimammography compared with mammography. RESULTS: Sensitivity, specificity, and positive and negative predictive value (%) of 99mTc scintimammography were 95, 96, 97 and 92, respectively. The corresponding figures for standard mammography were 87, 26, 68 and 52. Scintimammography changed the 34 false positive mammograms into true negatives, at the expense of four false negatives. The sensitivity of scintimammography in detecting axillary lymph node metastases was 72% and specificity 100%. CONCLUSION: Scintimammography with 99mTc tetrofosmin seems to be of value in the detection of breast malignancy and axillary metastases. It may help to avoid unnecessary operations in patients whose mammograms do not give a definite diagnosis.     

超声与钼靶摄片对乳腺癌早期诊断的意义

目的： 评估超声与钼靶摄片检查在乳腺癌早期诊断中的作用,以提高乳腺癌的早期筛查效率。 方法：收集乳腺癌早期诊断的女性患者528例临床资料,其中经B超查出隐匿性乳腺癌132例,经钼靶摄片查出乳癌病灶396例。比较两种检查方式获得初步诊断的乳腺癌患者的临床与影像学特征、手术方式与组织病理学特征、分子生物学标志物与分型的差异。 结果：两者比较显示,绝经前、年青、汉族（相对维吾尔族）女性及致密乳房组织和影像学BI-RADS 4级的乳腺癌超声检查较钼靶摄片更易检出（均P<0.05）;超声检查较钼靶摄片检出的患者更多实行保乳手术,且淋巴结转移阳性率较低,更易发现单发、直径≤1 cm、分化较好的乳腺癌及早期阶段的浸润性乳腺癌（均P<0.05）;超声检查对ER（+）、luminal A乳腺癌检出率高,而钼靶摄片对Her-2（+）、Her-2型乳腺癌检出率高（均P<0.05）。 结论：超声检查较钼钯摄片更容易发现致密乳房组织中的侵袭性与恶性程度较低的早期癌灶,对于检出不同分子分型的早期乳腺癌两者各有优势。故联合应用更利于乳腺癌患者早期筛查。     

男性乳腺癌的治疗及预后因素分析:附37例报告

目的　探讨男性乳腺癌 (MBC )的治疗和预后因素。方法　回顾性分析 3 7例男性乳腺癌的临床资料。手术方式包括经典根治术 (10例 ) ,改良根治术 (19例 ) ,单纯乳房切除术 同侧腋窝淋巴结摘除术 (4例 ) ,单纯乳房切除术 (4例 )等。结果　上述手术方式的患者 5年生存率依次为 80 .0 %,78.9%,2 5 .0 %,2 5 .0 %;腋窝淋巴结有转移和无转移的患者 5年生存率分别为 5 0 .0 %和 93 .3 %;雌激素受体 (ER)阳性和阴性的患者 5年生存率分别是 80 .0 %和 42 .8%(P <0 .0 5 ) ;结论　改良根治术是MBC的首选术式 ,术后可根据情况辅以其他治疗 ;腋窝淋巴结转移、病理类型及肿瘤分期等因素影响预后 ,其中手术方式和腋窝淋巴结状况为影响预后的主要因素。     

乳腺肿块中^99m锝标记的甲氧基异丁基异腈浓聚机理及临床意义的

OBJECTIVE: To study the accumulation of (99m)Tc-MIBI in breast cancer or benign lesions and the correlation between cell proliferation and angiogenesis. METHOD: (99m)Tc-MIBI positive imaging was performed on 38 patients with palpable breast mass. A ratio of radioactivity value of mass to normal tissue was assessed 10 minutes after injection of (99m)Tc-MIBI in posterior oblique view. Cell proliferation and angiogenesis were assessed by immunostaining of proliferating cell nuclear antigen (PCNA) and ulex europaeus I lectin (UEA- I). Data were analyzed by T-test, correlation and regression analysis. RESULT: We studied 17 true-positive, 5 false-negative, 15 true-negative, and 1 false positive patients (chi(2) = 18.74, P < 0.001). In patients with positive (99m)Tc-MIBI scans, the diameter of mass (4.00 +/- 1.95 cm) was larger and the percentage of PCNA positive cell (74.13% +/- 13.84%) was significantly higher than that in patients with negative scans (2.14 +/- 1.00 cm, 43.76% +/- 20.78%, P < 0.01). No significant evidence of difference between the number of angiogenic vessels of the two groups (181.3 +/- 71.7, 138.3 +/- 103.0, P = 0.141). The accumulation of (99m)Tc-MIBI was most strongly correlated with the percentage of PCNA positive cell (r = 0.56, P = 0.000), but was not related to the number of vessels (r = 0.31, P = 0.056). In stepwise regression analysis, the variance number of vessels was not included in the model. CONCLUSION: The accumulation of (99m)Tc-MIBI in breast cancer is an indicator of cell proliferation, and no evident relationship with angiogenesis has been found.     

International prospective evaluation of scintimammography with (99m)technetium sestamibi

BACKGROUND: The purpose of this study is to evaluate the efficacy of scintimammography with (99m)Technetium-Sestamibi for the diagnosis of breast cancer. METHODS: This was a multicenter prospective cohort clinical trial. A total of 1,734 women were enrolled of whom 1,243 had complete data upon study completion. RESULTS: The mean +/- standard error age of the patients is 56 +/-12 years (with a range of 19 to 94). Mammographic results were classified by the Breast Imaging Reporting and Data System (BIRADS) as 199 (16%) BIRADS 5, 149 (12%) BIRADS 4, 199 (16%) BIRADS 3, and 696 (56%) BIRADS 2 or 1. Scintimammography was positive for 322 (26%) of the patients and negative for 921 (76%). Histopathology showed malignancy for 201 (16%) of the patients. Sensitivity and specificity of scintimammography was estimated 93% and 87% respectively. A positive predictive value (PPV) of 58% with a negative predictive value of 98% were calculated. CONCLUSIONS: The present study suggests that scintimammography with (99m)Technetium-Sestamibi is highly accurate for the detection of breast cancer.     

乳腺钼靶X线摄片计算机辅助定位穿刺活检术

目的 探讨乳腺钼靶照片在电子计算机辅助下立体定位穿刺活检对乳腺疾病诊断的价值。方法 对79例乳腺钼靶照片发现可疑病灶的患者,采用由电子计算机辅助定位仪立体定位,用穿刺针对病灶进行准确穿刺,取得活组织送病理检查。结果 79例所取活组织全部符合组织学检查要求。79例中68例行手术治疗,手术切除标本的石腊切片诊断符合率为97．1％（66／68）。结论 X线计算机辅助定位穿刺检查技术具有定位准确,创伤小,操作简单等优点,对诊断早期乳腺癌有重要价值。     

Clinical experience with 99mTc-MIBI scintimammography in patients with breast microcalcifications

The aim of this study was to evaluate whether 99mTc-MIBI scintimammography can improve the diagnostic value of mammography for the differentiation of benign and malignant breast microcalcifications. In 41 women presenting 45 clusters of microcalcifications, a 99mTc-MIBI scintimammography was performed before open biopsy. There were 24 malignant lesions (53%). The sensitivity (SE) and specificity (SP) of 99mTc-MIBI scintimammography were 58.3% and 81%, and the positive and negative predictive values (PPV, NPV) were 78% and 63%, respectively. SE and PPV increased for lesions over 10 mm and for the younger patients (under 50 years). No correlation was found between true positive uptake and breast cancer invasiveness: 69% (9/13) for invasive lesions and 45% (5/11) for noninvasive lesions (P = 0.48). 99mTc-MIBI scintimammography was more often positive in high grade than in low- or intermediate-grade ductal carcinoma in situ (P = 0.03). The results were analysed according to the morphologic aspect of the microcalcifications. 99mTc-MIBI scintimammography could not be used for routine evaluation of all the microcalcifications detected by mammography.     

隐匿性乳腺癌36例诊治分析

目的探讨隐匿性乳腺癌的诊断和治疗方法。方法对36例隐匿性乳腺癌患者分别采用乳房X线、MRI检查,对肿块切除活检病理免疫组化检查;治疗采用乳腺癌根治术、改良根治术或保乳术后加放疗。结果乳腺钼靶的阳性率45．8％（11／24）,MRI的阳性率70％（7／10）;免疫组化检查阳性率62％（18／29）;乳腺癌根治术、改良根治术和保乳术后加放疗的5年生存率分别73．9％、77．8％（P〉0．05）。结论乳腺钼靶和MRI有重要诊断价值,切检和免疫组化检查有助于确诊;乳腺癌根治术或改良根治和保乳术后放疗的5年生存率相同。     

青少年乳腺恶性肿瘤

目的为探讨３５岁以下青少年乳腺恶性肿瘤的生物学特征以及诊断、处理和预后的特殊性。方法对１９９１～１９９５年收治的３５岁以下的４１例青少年乳腺恶性肿瘤的临床资料进行分析。结果浸润性导管癌发生率明显为高,５年存活率较文献报道的综合年龄组低。结论青少年乳腺恶性肿瘤的预后与病期有关。