18FFDG显像在乳腺癌新辅助化疗疗效评价中应用.doc

18FFDG显像在乳腺癌新辅助化疗疗效评价中应用 　【摘要】 　　目的 探讨18FFDG PET显像评价乳腺癌新辅助化疗疗效应用价值。方法 对31例经细针穿刺或针吸细胞活检确诊为原发性乳腺癌的患者在FAC方案化疗前、后分别行18FFDG PET显像，根据PET显像结果计算乳腺癌病灶放射性摄取比值(T/NT)；3个疗程结束后评价疗效，以WHO制定的肿瘤化疗评价标准分为有效组[R(+)，n=22]和无效组[R(-)，n=9]；以第3疗程结束后T/NT比值降低百分率≥10%、≥20%、≥30%作为监测治疗有无反应的阈值进行疗效判定。临 床 军 医 杂 志 (Clin J Med Offic)2007年12月 第35卷 第6期结果 化疗前R(+)组和R(-)组T/NT比值分别为3.18±0.41、3.14±0.52(Pgt;0.05)，化疗第3疗程后R(+)组T/NT比值从3.18±0.41降低为2.06±0.45(Plt;0.05)，而R(-)组T/NT比值从3.14±0.52降低为2.87±0.27(Pgt;0.05)；R(+)组T/NT比值降低的百分率为（33.42±6）%，明显高于R(-)组（8.89±6）%(Plt;0.01)；若以第3疗程结束后T/N比值降低百分率≥10%、≥20%、≥30%作为监测治疗有无反应的阈值，18FFDG PET评价疗效的灵敏度、特异性分别为100%、89%、82%和85%、92%、100%。结论 18FFDG PET显像对乳腺癌新辅助化疗早期疗效的评价具有一定的临床价值。 【关键词】 18FFDG；乳腺肿瘤；新辅助化疗；疗效 　　Abstract： Objective To study the application value of response to neoadjuvant chemotherapy in breast cancer using 18Ffluorodeoxyglucose (FDG) positron emission tomography (PET). Methods Thirtyone primary breast cancer patients finally diagnosed by fine needle aspiration examination accepted 18FFDG PET imaging examination before and after three cycles of FAC chemotherapy. Calculation was carried out for the tumortonormal tissue background (T/NT) value in the focus of the cancer. According to WHO criterion, the patients were divided into two groups after therapy, i.e. effective group [R(+), n=22] and noneffective group [R(-), n=9]. According to the T/NT declining percentage (such as≥10%, ≥20% and ≥30%), the patients’curative effects were evaluated respectively.Results The T/NT values of group R(+) and group R(-) were respectively 3.18±0.41 and 3.14+0.52 (Pgt;0.05) before chemotherapy. After chemotherapy the T/NT of group R(+) went down to 2.06±0.45 (Plt;0.05), and the T/NT of group R(-) down to 2.87±0.27 (Pgt;0.05). The declining percentage of R(+) was 33.42%±6%, obviously higher than that of R(-) group (8.89%±6%, Plt;0.05). Based on the declining percentage of T/NT (≥10%, ≥20% and ≥30%), the sensitivity and specificity of 18FFDG PET were 100%, 89%, 82% (sensitivity), and 85%