Mulero F, Nicolás F, Castellón M I, Claver M A, Abad L, Nuño de la Rosa J A
Servicios de Medicina Nuclear y Ginecología y Obstetricia del Hospital Universitario Virgen de la Arrixaca. El Palmar. Murcia.
Rev Esp Med Nucl. 2000 Oct;19(6):416-22. doi: 10.1016/s0212-6982(00)71903-3.
The presence of affected locoregional lymph nodes should be considered as one of the most important prognostic factors of breast cancer. At present, the clinician is conditioned by an absolute lack of an efficient methodology to evaluate the possible invasion of the axillary lymph nodes, which if negative, would make it possible to avoid surgical excision. In this study, we will evaluate the use of the 99mTc-MIBI scintigraphy in the pre-surgical diagnosis of axillary lymph node invasion and will analyze the relationship between the 99mTc-MIBI uptake and the number of lymph nodes affected.
84 patients diagnosed of breast cancer were analyzed in this study. All of them underwent a 99mTc-MIBI scintigraphy, and the tumor/background ratio was determined semiquantitively for each image. The axillary lymph node invasion was determined following surgery.
The sensitivity of the breast scintigraphy with 99mTc-MIBI for detection of lymph node invasion is 36% and the specificity is 100%. The positive predictive value is 100% and the negative one 48%. In the current study, we failed to detect correlation between the intensity of 99mTc-MIBI uptake in the primary tumor and the number of affected axillary lymph nodes.
99mTc-MIBI breast scintigraphy can provide complementary information for the presurgical diagnosis of breast cancer axillary lymph node invasion. 99mTc-MIBI breast scintigraphy shows high specificity and a high predictive value.
受累区域淋巴结的存在应被视为乳腺癌最重要的预后因素之一。目前，临床医生受到缺乏有效方法来评估腋窝淋巴结可能侵犯情况的限制，如果腋窝淋巴结为阴性，则有可能避免手术切除。在本研究中，我们将评估99mTc-MIBI闪烁扫描在腋窝淋巴结侵犯术前诊断中的应用，并分析99mTc-MIBI摄取与受累淋巴结数量之间的关系。
本研究分析了84例诊断为乳腺癌的患者。所有患者均接受了99mTc-MIBI闪烁扫描，并对每个图像进行半定量测定肿瘤/本底比值。术后确定腋窝淋巴结侵犯情况。
99mTc-MIBI乳腺闪烁扫描检测淋巴结侵犯的敏感性为36%，特异性为100%。阳性预测值为100%，阴性预测值为48%。在本研究中，我们未能检测到原发肿瘤中99mTc-MIBI摄取强度与受累腋窝淋巴结数量之间的相关性。
99mTc-MIBI乳腺闪烁扫描可为乳腺癌腋窝淋巴结侵犯的术前诊断提供补充信息。99mTc-MIBI乳腺闪烁扫描显示出高特异性和高预测价值。
