乳腺专用γ显像的肿瘤/正常组织比值与乳腺浸润性导管癌病理学的对比研究

目的 探讨乳腺专用γ显像（BSGI）的肿瘤摄取半定量方法与乳腺浸润性导管癌（IDC）临床病理学的对比研究。 方法 回顾性分析2016年4月至2017年8月贵州省人民医院符合纳入标准的84例女性IDC患者，年龄30~76（53.2±13.1）岁。患者术前均行BSGI检查，通过乳腺影像报告和数据系统（BIRADS）对BSGI图像进行视觉评分。根据BSGI的阳性结果，将肿瘤与正常组织放射性比值（TNR）与病理学结果进行比较，阳性与阴性结果的比较采用t检验和χ2检验，多组病理亚型的比较采用方差分析；采用单因素分析、多因素分析和Pearson积差相关性分析明确TNR与组织病理学因素之间的相关性。 结果 84例IDC患者BSGI诊断为阳性75例，灵敏度为89.3%（75/84）。单因素分析结果显示，肿瘤大小（t=4.13，P<0.01）、腋窝淋巴结是否转移（χ2=5.04，P=0.005）、病理组织学分级（F=11.05，P=0.034）、孕激素受体（PR）表达（χ2=3.12，P=0.041）和细胞增殖核抗原Ki-67（简称Ki-67)指数（χ2=16.20，P=0.008）的差异对TNR的影响有统计学意义。多因素分析结果显示，乳腺癌的病理危险因素有肿瘤长径≥2 cm、腋窝淋巴结转移和PR阴性（OR=2.186、1.673、0.420，P=0.004、0.047、0.032）。Pearson相关性分析结果显示，TNR与肿瘤大小的相关性较差（r=0.353，P=0.004）；与Ki-67指数呈中度正相关（r=0.452，P=0.014）；与PR Allred评分呈负相关（r=−0.364，P=0.026）。 结论 BSGI的高TNR与乳腺癌病理不良因素相关，TNR可作为乳腺癌预后评估的有价值的预测指标。

Compared study of tumor uptake target to normal tissue ratio on breast-specific gamma imaging with clinical pathology in invasive ductal breast carcinoma

Objective To investigate the correlation between tumor uptake target to normal tissue ratio (TNR) obtained from breast-specific gamma imaging (BSGI) and the pathology of breast cancer. Methods A total of 84 female patients aged 30−76(53.2±13.1) years who had visited Guizhou Provincial People's Hospital with a diagnosis of invasive ductal carcinoma and who underwent preoperative BSGI were retrospectively enrolled from April 2016 to August 2017. The BSGI images of these patients were visually scored from 1 to 5 according to a breast imaging reporting and data system (BIRADS). The TNR results obtained from positive BSGI images were compared in terms of breast cancer pathology. T test and chi-square test were used for the comparison of positive and negative results, and analysis of variance was used for the comparison of pathological subtypes among multiple groups.Multiple regression analysis was performed using histologic factors; significant, independent factors were determined by P values less than 0.05 in the univariate analysis. The correlations between TNR and histopathologic factors were analyzed by Pearson’s correlation coefficient. Results Among 84 images, 75 were classified with positive findings (sensitivity 89.3%, 75/84). A higher TNR value was significantly correlated with tumor size (t=4.13, P<0.01), axillary lymph node metastasis (χ2=5.04, P=0.005), histologic grade(HG) (F=11.05, P=0.034), progestrone receptor(PR) status (χ2=3.12, P=0.041), and Ki-67 (χ2=16.20, P=0.008). Multivariate analysis revealed that the pathological risk factors of breast cancer are related to tumor size tumor size≥2 cm, axillary lymph node metastasis, and negative PR status (OR=2.186, 1.673, 0.420; P=0.004, 0.047, 0.032). Pearson correlation analysis showed that TNR is weakly correlation with tumor size (r=0.353, P=0.004), moderately positively correlated with Ki-67 (r=0.452, P=0.014), a weak negative correlation with the Allred score of PR status (r=−0.364, P=0.026). Conclusion High TNRs in BSGI imaging may be associated with the adverse pathological factors of breast cancer.This parameter may could be a valuable prognostic indicator of breast cancer.