99mTc-MIBI乳腺显像对乳腺肿物良恶性及淋巴结转移的诊断价值

目的：探讨＾９９ｍＴｃ－ＭＩＢＩ乳腺显像对乳腺癌及淋巴结转移的诊断价值。方法：６８例单侧乳乳腺肿物的女性患者。从病变乳腺对侧的肘静脉注入＾９９ｍＴｃ－ＭＩＢＩ７４０ＭＢｑ,１０ｍｉｎ后分别行前位、侧位乳腺显像。结果：６８例乳腺肿物患者,经病理证实恶性３８例,良性３０例。＾９９ｍＴｃ－ＭＩＢＩ乳腺显像阳性共３７例,其中乳腺癌３４例,乳腺良性肿瘤３例。＾９９ｍＴｃ－ＭＩＢＩ乳腺显像诊断乳腺癌的灵敏性为８９．５％,特异性为９０％,阳性预测值为９１．９％,阴性预测值为８７．１％;３８例乳腺癌患者８例淋巴结转移,６例＾９９ｍＴｃ－ＭＩＢＩ显像阳性。结论：＾９９ｍＴｃ－ＭＩＢＩ乳腺显像可成为诊断乳腺癌及鉴别乳腺肿物良恶性较可靠的无创性方法,其对淋巴结转移的检测也有一定价值。     

^99mTc—MIBI显像对乳腺肿块良恶性的鉴别病理学分析

目的 探索此项检查诊断乳腺癌的临床应用价值及其与病理类型的关系。方法 ６０例女性乳腺肿块病人，静脉注射＾９９ｍＴｃ－ＭＩＢＩ７４０￣９２５ＭＢｑ／人后５￣１０ｍｉｎ静态显人像。计算Ｔ／ＮＴ比值，检查后一周同手术。结果 此方法诊断乳腺癌的灵敏度为８０．４％，特异性为９２．８％。其阳性率随组织病理学特点不同而差异明显。对癌细胞密度相对较低的乳腺癌显像的易造成假阴性。结论 ＾９９ｍＴｃ－ＭＩＢＩ乳腺显像     

^99mTc—MIBI腋窝显像在早期乳腺癌中的应用

目的：评价＾９９ｍ锝标记的甲氧基异丁基异腈（＾９９ｍＴｃ－ＭＩＢＩ）腋窝显像在早期乳腺癌中的应用价值。方法：随机选取４０例同侧腋窝无肿大淋巴结的住院乳腺癌患者,术前３位＾９９ｍＴｃ－ＭＩＢＩ显像,计算病变与周围正常组织的放射性比值,以术后病理检查为金标准,判断该方法在诊断腋窝淋巴结转移的敏感性、特异性及准确性。结果：＾９９ｍＴｃ－ＭＩＢＩ腋窝显像敏感性７８．６％（１１／１４）,特异性为８４．６％（２２／２６）,准确性为８２．５％（３３／４０）。结论：＾９９ｍＴｃ－ＭＩＢＩ腋窝显像有助于早期乳腺癌手术方案的选择。     

99Tcm-MIBI乳腺显像鉴别乳腺肿块良恶性的初步临床观察

目的 寻找简便、灵敏度高、无创伤性的诊断原发乳腺癌的方法,了解＾９９Ｔｃ＾ｍ－ＭＩＢＩ显像对乳腺癌的鉴别诊断价值。方法 对１３３例患者进行了＾９９Ｔｃ＾ｍ－ＭＩＢＩ乳腺显像。同时与红外线扫描进行了比较。结果 １３３例中乳腺癌６３例,良性肿块７０例,灵敏度８５．７％,特异性８０．０％,诊断符合率８２．７％。结论＾９９Ｔｃ＾ｍ－ＭＩＢＩ对乳腺肿块良、恶性的诊断有一定的价值,优于红外线扫描检查,对区域淋     

^99mTc—MIBI显像诊断甲状腺癌的临床价值

目的 探讨＾９９ｍＴｃ－甲氧基异丁基异睛（ＭＩＢＩ）对鉴别甲状腺冷（凉）结有恶性的临床价值。方法 对６１例＾９９ｍＴｃ－高得酸钠（＾９９ｍＴｃＯ４＾－）显像为冷（凉）结节的患者行＾９９ｍＴｃ－ＭＩＢＩ显像１５例阳性,其中６例有淋巴结转移者淋巴结均呈阳性;另外４４例为甲状腺良性病变,８例假阳性。诊断的灵敏度、特异性和假阳性率分别为８８．２４％（１５／１７）,８．８２％（３６／４４）和１８．１８％（８     

120例乳腺癌术后核素骨显像分析

目的 对１２０例乳癌术后患者行全身核素骨显像,诊断有无骨转移灶。方法 用＾９９ｍＴｃ－ＭＤＰ静注后２－３小时显像。结果 有７７例核业像阳性,占６４．１％,其中５６例与Ｘ线检查相对照,核素骨显像阳性４６５例,占８２．１％,Ｘ线阳性１７例,占３０．３％。结论核素骨显像明显优于Ｘ线检查。乳腺癌术后应定期行全身核素骨显像,对早期发现病灶,进行及时治疗,具有一定     

^99mTc—tetrofosmin显像诊断乳腺癌及腋窝淋巴结转移癌

本文综述＾９９ｍＴｃ－ｔｅｔｒｏｆｏｓｍｉｎ显像诊断乳腺癌及淋巴结转移癌的研究进展,显示其对乳腺肿瘤良恶性鉴别及腋窝淋巴结转移癌的检查有临床意义,对乳腺恶性病变的检出优于＾９９ｍＴｃＭＩＢＩ,是一种简便,安全,可靠的诊断技术。     

乳腺肿瘤核素显像诊断研究进展

无创性诊断和鉴别诊断乳腺肿瘤是近年来开展研究较多课题。本文介绍了目前核素乳腺显像（ＳＭＭ）在这方面的研究进展，综合分析了几种常见显像＾２０１Ｔｌ，＾９９ｍＴｃ－ＭＩＢＩ，＾９９ｍＴｃ－ＭＤＰ等，提示ＳＭＭ在鉴别乳腺肿瘤良恶性方面优于乳腺Ｘ线像（ＭＡＭＭ）特别是对于青壮年致密型乳腺和ＭＡＭＭ难与乳癌鉴别的乳腺腺病，ＳＭＭ更显示出优势，避免了对患者进行了不必要的手术活检和针吸活检，ＳＭＭ无创，简便实用     

99mTC-tetrofosmin显像诊断乳癌及腋淋巴结转移的临床价值

目的 评估＾９９ｍＴＣ－ｔｅｔｒｏｆｏｓｍｉｎ显像诊断乳腺和腋淋巴结转移癌的临床价值。方法 对５２例乳腺肿病人进行＾９９ｍＴＣ－ｔｅｔｒｏｆｏｓｍｉｎ显像。全部患者均在２周内行外科手术治疗,并作病理诊断对照。结果 ２６例患者病理主宰患有乳腺癌。３９例为良性病变。＾９９ｍＴＹＣ－ｔｅｔｒｏｆｓｍｉｎ显像发现了乳癌中的２１例,以及１６例合并有腋窝淋巴结转移癌中的１１例。＾９９ｍＴＣ－ｔｅｔｒｏｆｏｓｍ     

99mTc-MIBI肺显像测定非小细胞肺癌P-糖蛋白表达

目的 研究＾９９ｍＴｃ－ＭＩＢＩ（甲氧基乙丁基异腈）肺显像定性检测非小细胞肺癌Ｐ－糖蛋白（Ｐ－ＧＰ）及与化疗效果对比。方法 采用二时相平面显像,以病灶处９９ｍＴｃ－ＭＩＢＩ的潴留指数（ＲＩ）为Ｐ－ＧＰ定性指标,ＲＩ〈０为Ｐ－ＧＰ阳性,以ＷＨＯ标准将疗效分为完全或者部分缓解（ＣＲ,ＰＲ）无变化（ＮＣ）,进展（ＰＤ）,将Ｐ－ＧＰ定性结果与疗效比较。     

THE CLINICAL SIGNIFICANCE OF ~(99m)Tc-MIBI BREAST IMAGING IN THE DIAGNOSIS OF EARLY BREAST CANCER

The incidence of breast cancer is increasing in China and it will be the most common malignant tumor in women in the early stage of this century[1]. 99mTc-MIBI breast imaging, an effective, sensitive, specific and noninvasive diagnostic method of breast cancer, has been attracting the attention of physicians. From March, 1994 to September, 1999, 109 breast masses smaller than 2 cm in diameter in 102 patients in Huashan Hospital were divided into three groups to undergo 99mTc-MIBI breast i…     

乳腺导管内癌20例临床分析

我院自１９７９年１月至１９９３年１２月经手术治疗乳膜癌３５７例，其中导管内癌２０例，占５．６％。首发症状为肿块者占６０％（１２／２０），乳头溢液者占２５％，乳头湿疹样改变者占１０％，肿埠伴溢液者占５％。腋窝淋巴结转移者占１０％。５年生存率９１．７％。分析认为，某些管内癌症状不典型，易漏诊、误诊，应引起重视。对术式的选择以改良根治术为首选。     

~(99m)Tc-MIBI显像对乳腺肿块良恶性的鉴别及病理学分析

目的 探索此项检查诊断乳腺癌的临床应用价值及其与病理类型的关系.方法 60例女性乳腺肿块病人,静脉注射~(99m)TC-MIBI740～925MBq/入后5～10min静态显像.计算T/NT比值,检查后一周内手术.结果此方法诊断乳腺癌的灵敏度为80.4%,特异性为92.8%.其阳性率随组织病理学特点不同而差异明显.对癌细胞密度相对较低的乳腺癌显像时易造成假阴性.结论 ~(99m)TC-MIBI乳腺显像对鉴别乳腺良恶性病变,尤其在评价内乳淋巴结和腋窝淋巴结是否转移及术后残留复发方面具有良好的临床应用价值.     

肺癌纵隔淋巴结转移核素断层显像的病理学基础

目的研究评价99mTc-MIBI SPECT术前诊断肺癌及纵隔转移淋巴结的价值.方法随机选取本院胸外科1997年3月～2000年12月间初诊"肺部阴影待查"患者100例,术前常规检查并加行99mTc-MIBI SPECT检查.男80例,女20例,平均年龄57.61±10.99岁.肺癌手术中规范清扫纵隔各组淋巴结,光学显微镜观察.计算核素断层显像之诊断敏感性,特异性,准确性,阳性预测值,阴性预测值,阳性拟然比、阴性拟然比等指标.对转移淋巴结假阴性显像,配对进行淋巴结图像分析,获取各切片转移癌细胞的面积值(μm2)及其面积百分比.结果 (1)99mTc-MIBI SPECT对支气管肺癌的诊断评价敏感性(93.67%),特异性(61.90%),准确性(87.00%),阳性预测值(90.24%),阴性预测值(72.22%),阳性拟然比(2.47)及阴性拟然比(0.10).(2)99mTc-MIBI SPECT对纵隔转移淋巴结的诊断评价敏感性(85 19%),特异性(93.62%),准确性(90.54%),阳性预测值(85.19%),阴性预测值(93.62%),阳性拟然比(13.28)及阴性拟然比(13.28)及阴性拟然比(0.16).(3)淋巴结图像分析显示淋巴结中转移癌细胞的数量同显像与否既有一定联系又非密切相关,淋巴结癌细胞数量(面积)并不是其显像与否的唯一因素.结论本组显示了SPECT在肺癌诊断鉴别和纵隔转移淋巴结预测上的独特价值,为外科手术中定向摘除淋巴结提供了定性和定量的方法.     

CK19和hMAM及SBEM检测乳腺癌微转移价值分析

目的：探讨生物学标志乳腺上皮小黏蛋白（smallbreastepithelialmucin,SBEM）、乳腺珠蛋白（humanmamma—globin,hMAM）和细胞角蛋白19（cytokeratin19,CK19）检测乳腺癌外周血及淋巴结微转移的临床应用价值。方法：收集2012-04—13—2012-10—10广西医科大学附属肿瘤医院乳腺外科首诊的患者外周血及组织标本。采用巢式PCR技术对47例乳腺癌患者和45例乳腺良性肿瘤患者外周血有核细胞中SBEM、hMAM和CK19的mRNA进行检测;采用半定量PCR技术对10例乳腺癌组织及对应的癌旁组织,以及10例乳腺良性肿瘤患者组织mRMA进行检测;采用免疫组化技术对其中27例乳腺癌患者的109个淋巴结进行检测。结果：乳腺癌和乳腺良性肿瘤患者的外周血SBEM表达率分别为82．98％（39／47）和62．22％（28／45）,χ2=5．005,P=0．021;乳腺癌和乳腺良性肿瘤患者的外周血hMAM表达率分别为65．96％（31／47）和42．22％（19／45）,差异有统计学意义,χ2=5．220,P=0．022;乳腺癌和乳腺良性肿瘤患者的外周血CK19表达率分别为89．36％（42／47）和80．00％（36／45）,差异无统计学意义,χ2=1．562,P=0．211。免疫组化CK19在52个转移性淋巴结中强阳性表达,在57个常规病理检查未发现的转移性淋巴结中检出5个淋巴结存在转移灶;hMAM及SBEM在转移性淋巴结中表达比CK19弱,而且阳性细胞染色不均一。结论：SBEM、hMAM和CK19作为乳腺癌外周血微转移生物学标志具有较高的灵敏性,但缺乏特异性,联合检测可以提高特异性,对发现早期乳腺癌微转移有一定临床意义;CK19可用于检测乳腺癌腋窝淋巴结的微小转移灶。     

~(99m)TcMIBI乳腺显像对乳腺肿物良恶性及淋巴结转移的诊断价值

目的 :探讨99mTc MIBI乳腺显像对乳腺癌及淋巴结转移的诊断价值。方法 :6 8例单侧乳腺肿物的女性患者 ,从病变乳腺对侧的肘静脉注入99mTc MIBI 740MBq ,10min后分别行前位、侧位乳腺显像。结果 :6 8例乳腺肿物患者 ,经病理证实恶性 38例 ,良性 30例。99mTc MIBI乳腺显像阳性共 37例 ,其中乳腺癌 34例 ,乳腺良性肿瘤 3例。99mTc MIBI乳腺显像诊断乳腺癌的灵敏性为 89 5 % ,特异性为 90 % ,阳性预测值为 91 9% ,阴性预测值为87 1% ;38例乳腺癌患者 8例淋巴结转移 ,6例99mTc MIBI显像阳性。结论 :99mTc MIBI乳腺显像可成为诊断乳腺癌及鉴别乳腺肿物良恶性较可靠的无创性方法 ,其对淋巴结转移的检测也有一定价值     

Technetium-99m methylene diphosphonate scintimammography for evaluation of palpable breast masses

Technetium-99m-methylene diphosphonate (Tc-99m MDP) scintimammography (SMB) was used to investigate palpable breast masses during routine presurgical bone scintigraphy, for women at high risk for cancer and who were candidates for surgery or excisional biopsy. Upright anterior and prone lateral views of the breasts were acquired from 65 women with palpable breast masses, 5-10 min after intravenous injection of 740 MBq of Tc-99m MDP. Breast cancer was histologically diagnosed in 50 women (77%) and benign disease was found in 15 women (23%). Of these 50 breast cancer patients, 44 (88%) showed abnormal MDP uptake in breasts. Among the 15 cases of benign lesions, only 1 (7%) showed abnormal MDP uptake in the breasts. The diagnostic sensitivity, specificity, and accuracy were 88%, 93%, and 89%, respectively, for the differentiation of malignant and benign breast masses. Scintimammography with Tc-99m MDP is a useful and cost-effective tool for differentiating malignant breast masses from benign breast masses.     

真空辅助旋切微创术对超声检查良性乳腺实性肿块的诊治价值

目的探讨真空辅助旋切微创手术对超声检查为良性乳腺实性肿块的诊治价值。方法收集2008年1月至2009年6月在本院乳腺病中心超声检查为乳腺影像报告和数据系统分级(Breast Imaging Reporting and Data System,BI-RADS)2、3、4级的良性乳腺实性肿块患者831例,所有患者行真空辅助旋切微创手术。对患者的超声检查、手术及病理资料进行回顾性分析。结果根据超声检查BI-RADS分级,2级167例、3级588例、4级76例。831例患者共检出肿块1383处,所有乳腺肿块均被准确、完全切除,全部患者切口隐蔽,乳房无变形,有较好的外观美观效果。831例患者中,良性病变822例,占所有病例的98.92%,乳腺癌9例占所有病例的1.08%,其中临床分期I期8例,Ⅱa期1例.418例不可扪及肿物患者中检出1例乳腺癌,占不可扪及患者的0.24%,占所有病例的0.12%(1/831)。413例可扪及肿物患者中检出8例乳腺癌,占可扪及患者的1.94%,占所有病例的0.96%(8/831)。588例BI-RADS3级病例中检查出3例乳腺癌,76例BI-RADS4级病例中检查出6例乳腺癌。结论真空辅助旋切微创手术诊治超声检查良性乳腺实性肿块不仅美容效果好,而且定位准确能全切除良性病变,更重要的是能检出临床上考虑良性肿块中的早期乳腺癌。     

乳腺肿瘤组织中血管形成的研究

目的：探讨血管形成在乳腺肿瘤生物学特征判定中作用及其与VEGF表达和CDPI血流检出率之间的相关关系。方法：对103例乳腺肿块行CDPI血流检测,术后切除标本均采用免疫组化方法检测VEGF的表达。结果：乳腺肿块CDPI血流检测阳性率83．5％（86／103）,其中乳腺癌占76．7％（66／86）,良性肿块为23．3％（20／86）;乳腺癌组织VEGF表达水平远远高于良性肿块,且LN^ 组高于LN^-组（P＜0．05）。乳腺癌中VEGF表达率与CDPI血流检出率趋于正相关变化。结论：血管生成增多与乳腺肿瘤的生长、浸润和转移等生物学行为关系密切,检测VEGF和CDPI对判定肿瘤内血管形成水平有重要意义。     

Diagnostic evaluation of cancer antigens RAK .1. Cervical and ovarian cancer

Three different tracers, Tc-99m-Sesta MIBI, In-111-Pentetreotide and F-18-FDG, were evaluated in a preliminary study in three different groups of 10 breast cancer patients programmed for breast cancer resection and axillary dissection. Planar scintigraphy and single photon emission tomography (SPET) technique were used for imaging with Tc-99m-Sesta-MIBI and In-111-Pentetreotide, positron emission tomography (PET) was used for imaging with F-18-FDG. We studied 30 breast cancer patients; their clinical stage according to the TNM classification was 30 T1-T2, 1 T4 and 1 Tx (one patient had bilateral cancer and one had bifocal cancer). The lymph nodal status ranged from NO to N2 (14 NO, 16 N1, 1 N2). Tc-99m-Sesta MIBI, In-111 Pentetreotide SPET and F-18-FDG PET were randomly performed before surgery to visualize the primary tumors and to detect axillary lymph node invasion. Tc-99m-Sesta MIBI correctly visualized 10 out of 11 primary cancers in 10 patients. In-111-Pentetreotide detected 9 out of 10 primary cancers. F-18-FDG imaged all the tumors (10). As regards the axillary nodes, Tc-99m-MIBI excluded axilla involvement in 7 out of 7 negative axillae (N-), while it was positive in 2 out of 3 positive cases (N+); In-111-Pentetreotide correctly identified 7 out of 8 negative axillae (N-), while it detected 2 of 3 positive sites. F-18-FDG visualized all positive axillary lymph nodes (4 out of 4 N+ patients) and correctly excluded involvement in all negative patients (6 out of 6 N- cases). This study demonstrated that all three tracers are adequate to be proposed as tumor seeking agents with the aim of developing non-invasive diagnostic methods for pre-operative detection of axillary metastases, so that surgical dissection can be limited to selected patients. The authors discuss the advantages and disadvantages of the different radiopharmaceuticals and conclude that in centers with PET facilities F-18-FDG is the best tumor seeking agent for the evaluation of axillary status. Between Tc-99m-Sesta MIBI and In-111-Pentetreotide the former seems to present more advantages in this kind of application, considering also its lower cost and easier availability. These results encourage further study, including the simultaneous comparison of these tracers in breast cancer staging.