PET/CT诊断乳腺癌及腋窝淋巴结状态的作用评价

目的：评价PET／CT诊断乳腺癌和腋窝淋巴结转移的临床价值。方法：对33例疑似乳腺癌病人进行PET／CT检查，定性分析肿瘤病灶、淋巴结摄取氟脱氧葡萄糖（FDG）的程度，半定量测量标准摄取值（SUV），根据乳腺和淋巴结的FDG摄取强度诊断乳腺癌和淋巴结转移，检验SUV与乳腺癌分化程度、有丝分裂计数的关联性。结果：PET／CT诊断乳腺癌和腋窝淋巴结转移的敏感度、特异度和精确度分别为92．6％、100％、93．9％和82．3％、90％、85．2％；SUV与乳腺癌分化程度、有丝分裂计数显著相关（P〈0．05）；诊断乳腺癌的Kappa指数=0．835，μ=8．48，（P〈0．01）。结论：PET／CT诊断乳腺癌和腋窝淋巴结转移的敏感度、特异度较高，作为一种非侵袭性检查方法，可提供乳腺癌在活体内的多方面生物学信息，为选择合理的手术方式及新辅助化疗提供参考，弥补传统检查方法的不足。

Evaluation of PET/CT imaging in diagnosing breast cancer and axillary lymph node metastases

Objective To evaluate the value of PET/CT in diagnosing breast cancer and axillary lymph node metastasis.Methods Before definite therapy,thirty-three patients with suspicious breast cancer underwent PET/CT ima-ging.The images of the breast and lymph node were analyzed for objective assessment of increased tracer uptake and standard uptake value(SUV).The specimens were assessed for cellular differentiation and mitotic activity index(MAI).Results Among 27 patients with breast cancer determined by pathology,25 cases showed positive results diagnosed by PET/CT,and 2 cases showed false-negative results,there was no false-positive.In 17 patients with axillary lymph node metastasis,14 cases were confirmed,there were 3 false-negative and 9 true-negative results.The sensitivity,specificity and accuracy of PET/CT in identifying breast cancer and axillary lymph node metastasis were 92.6%,100%,93.9% and 82.3%,90%,85.2% respectively.A significant association was found between SUV and tumor differentiation and MAI,P<0.05.Conclusions PET/CT imaging possesses high sensitivity and specificity in diagnosing breast cancer and axillary lymph node metastasis,it could be used noninvasively to assess primary breast cancer and axillary lymph node status,and to estimate tumor differentiation and proliferation in vivo,so it is helpful as a complimentary method in a subgroup of patients with indeterminate results of conventional breast imaging.