Gil-Rendo A, Zornoza G, García-Velloso M J, Regueira F M, Beorlegui C, Cervera M
Department of General Surgery, Clinica Universitaria of Navarra, C/Pío XII 36, 31008 Pamplona, Navarre, Spain.
Br J Surg. 2006 Jun;93(6):707-12. doi: 10.1002/bjs.5338.
This study analysed the value of [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting axillary lymph node involvement in women with breast cancer.
In the first 150 women in this prospective study, axillary lymph node dissection (ALND) was performed regardless of the PET results. In a second group (125 women) FDG-PET was complemented with sentinel lymph node biopsy (SLNB) only in those who did not have pathological axillary uptake.
The sensitivity and specificity of FDG-PET in detecting axillary involvement was 84.5 and 98.5 per cent respectively in the whole series of 275 patients, with two false-positive and 22 false-negative results. False-negative results were associated with some intrinsic tumour characteristics. In 21 women, PET revealed pathological uptake, suggesting involvement of the internal mammary lymph node chain. Whole-body PET identified a second synchronous tumour in five asymptomatic patients and haematogenous metastases in two patients.
The high positive predictive value of PET (98.4 per cent) suggests that FDG uptake in the axilla could be an indication for full ALND without previous SLNB.
本研究分析了[18F]氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在检测乳腺癌女性腋窝淋巴结受累情况中的价值。
在这项前瞻性研究的前150名女性中，无论PET结果如何，均进行腋窝淋巴结清扫术（ALND）。在第二组（125名女性）中，仅对那些腋窝无病理性摄取的患者，FDG-PET联合前哨淋巴结活检（SLNB）。
在整个275例患者系列中，FDG-PET检测腋窝受累的敏感性和特异性分别为84.5%和98.5%，有2例假阳性和22例假阴性结果。假阴性结果与一些肿瘤固有特征相关。在21名女性中，PET显示病理性摄取，提示内乳淋巴结链受累。全身PET在5名无症状患者中发现了第二个同步肿瘤，在2名患者中发现了血行转移。
PET的高阳性预测值（98.4%）表明，腋窝FDG摄取可能是无需先行SLNB而直接进行完整ALND的指征。
