Lumachi F, Ermani M, Marzola M C, Zucchetta P, Cecchin D, Basso S M M, Brandes A A, Bui F
Breast Surgery Unit, Endocrinesurgery, Department of Surgical & Gastroenterological Sciences, University of Padua, School of Medicine, 35128 Padova, Italy.
Breast. 2006 Feb;15(1):130-4. doi: 10.1016/j.breast.2005.03.005. Epub 2005 Jun 27.
The complementary role of sestamibi scintimammography (SSM) in patients with breast cancer (BC) is well established. The aim of this study was to establish whether a relationship exists between sestamibi uptake, evaluated as a tumour-to-background ratio (TBR), and the main prognostic factors of BC. SSM with the measurement of TBR was performed preoperatively in 102 women (median age 57 years, range 32-81 years) who underwent curative surgery for primary BC. Final pathology showed 4 (3.9%) with pT1a, 17 (16.7%) with pT1b, 44 (43.1%) with pT1c and 37 (36.3%) with pT2 breast carcinomas. The overall sensitivity of SSM was 80.4%. An ANOVA showed significant (P<0.01) differences between the TBR of patients with G1 vs. G3 tumours, and between the TBR of those with G2 vs. G3 breast carcinomas. Moreover, there was a difference (P=0.021) between the TBR of patients (n=12, 11.8%) with CEA serum levels >10 ng/ml (2.031+/-0.420), and those with normal (n=90, 88.2%) CEA values (1.713+/-0.446), whilst no difference (P=NS) was found between patients (n=27, 26.5%) with CA 15-3 >30 U/ml (1.893+/-0.401) and those with normal (n=75, 73.5%) CA 15-3 values (1.699+/-0.462). There was a mild inverse correlation between TBR and both the oestrogen (R=0.25, P=0.011) and the progesterone receptor (R=0.23, P=0.02) rate. The logistic regression analysis showed that only size and CA 15-3 serum levels represent true independent parameters, but the function was able to predict only 11 out of 21 (52.4%) patients with false-negative SSM. TBR is independent of age and mainly correlates with the size of the tumour. There are no reliable preoperative prognostic factors that are really useful for improving SSM sensitivity in patients with small breast carcinomas.
在乳腺癌（BC）患者中，甲氧基异丁基异腈闪烁乳腺造影（SSM）的辅助作用已得到充分证实。本研究的目的是确定以肿瘤与本底比值（TBR）评估的甲氧基异丁基异腈摄取与BC的主要预后因素之间是否存在关联。对102例接受原发性BC根治性手术的女性（中位年龄57岁，范围32 - 81岁）术前进行了测量TBR的SSM检查。最终病理显示，pT1a期4例（3.9%），pT1b期17例（16.7%），pT1c期44例（43.1%），pT2期乳腺癌37例（36.3%）。SSM的总体敏感性为80.4%。方差分析显示，G1期与G3期肿瘤患者的TBR之间以及G2期与G3期乳腺癌患者的TBR之间存在显著差异（P<0.01）。此外，癌胚抗原（CEA）血清水平>10 ng/ml的患者（n = 12，11.8%）的TBR（2.031±0.420）与CEA值正常的患者（n = 90，88.2%）的TBR（1.713±0.446）之间存在差异（P = 0.021），而糖类抗原15 - 3（CA 15 - 3）>30 U/ml的患者（n = 27，26.5%）的TBR（1.893±0.401）与CA 15 - 3值正常的患者（n = 75，73.5%）的TBR（1.699±0.462）之间未发现差异（P = 无统计学意义）。TBR与雌激素（R = 0.25，P = 0.011）和孕激素受体（R = 0.23，P = 0.02）率均呈轻度负相关。逻辑回归分析表明，只有肿瘤大小和CA 15 - 3血清水平是真正独立的参数，但该函数仅能预测21例SSM假阴性患者中的11例（52.4%）。TBR与年龄无关，主要与肿瘤大小相关。对于提高小乳腺癌患者SSM的敏感性，术前没有真正有用的可靠预后因素。
