Papantoniou Vassilios, Tsiouris Spyridon, Koutsikos John, Sotiropoulou Maria, Mainta Ekaterini, Lazaris Dimitrios, Valsamaki Pipitsa, Melissinou Maria, Zerva Cherry, Antsaklis Aris
Department of Nuclear Medicine, "Alexandra" University Hospital, Athens, Greece.
Nucl Med Commun. 2006 Nov;27(11):911-7. doi: 10.1097/01.mnm.0000243367.73141.85.
To estimate whether breast uptake of (99m)Tc-(V)DMSA and (99m)Tc-sestamibi in usual ductal epithelial breast hyperplasia (UDH) and apocrine metaplasia is related to cell proliferation rate (Ki-67) and oestrogen receptor (ER) expression, both of which are associated with the potential risk of evolving to malignancy.
Among patients referred for suspicious breast findings on palpation and/or mammography and evaluated preoperatively with both radiopharmaceuticals, we retrospectively studied 17 (10 with UDH: group I; and seven with apocrine metaplasia: group II). Lesion-to-background (L/B) ratios in early and late acquisitions were calculated for both radiotracers in both groups, as well as their retention ratios. Ki-67 and oestrogen receptor expression were determined immunohistochemically. The late L/B ratios between the two tracers were compared, as were the late ratios for each tracer between Ki-67 < or = 3% and > 3%, and between ER < or = 15% and > 15%. Linear regression analysis was also performed between L/B and retention ratios and Ki-67 expression.
There was a significant increase of the (99m)Tc-(V)DMSA L/B ratio in late images as compared to the early images in group I (P<0.05), while in group II it was not significantly increased (P=0.084). (99m)Tc-sestamibi ratios did not demonstrate variability over time in either group (P=0.156 and 0.274, respectively). Significant coefficient correlation was found between the (99m)Tc-(V)DMSA L/B(late) ratios and retention ratios and Ki-67 levels only for group I (r=0.889, P<0.001 and r=0.802, P<0.01, respectively). The (99m)Tc-(V)DMSA L/B(late) ratios in group I were significantly higher when Ki-67 > 3% than when Ki-67 < or = 3% (P=0.016) but did not differ considerably between ER > 15% and < or = 15% (P=0.732).
(99m)Tc-(V)DMSA uptake in UDH correlates with Ki-67 expression. This could prove useful in identifying women with benign but high-risk breast pathologies who might benefit from chemoprophylaxis.
评估普通导管上皮乳腺增生（UDH）和大汗腺化生中乳腺对锝（99m）Tc-（V）二巯基丁二酸（DMSA）和锝（99m）Tc-甲氧基异丁基异腈（sestamibi）的摄取是否与细胞增殖率（Ki-67）和雌激素受体（ER）表达相关，这两者均与发展为恶性肿瘤的潜在风险有关。
在因触诊和/或乳腺X线摄影发现可疑乳腺病变而转诊且术前用两种放射性药物进行评估的患者中，我们回顾性研究了17例患者（10例UDH患者：第一组；7例大汗腺化生患者：第二组）。计算两组中两种放射性示踪剂在早期和晚期采集时的病变与本底（L/B）比值及其滞留率。采用免疫组织化学方法测定Ki-67和雌激素受体表达。比较两种示踪剂之间的晚期L/B比值，以及Ki-67≤3%和＞3%之间、ER≤15%和＞15%之间每种示踪剂的晚期比值。还对L/B和滞留率与Ki-67表达进行线性回归分析。
与早期图像相比，第一组晚期图像中锝（99m）Tc-（V）DMSA的L/B比值显著增加（P<0.05），而第二组未显著增加（P=0.084）。两组中锝（99m）Tc-sestamibi比值随时间均未显示出变化（分别为P=0.156和0.274）。仅在第一组中，锝（99m）Tc-（V）DMSA的L/B（晚期）比值与滞留率和Ki-67水平之间存在显著的系数相关性（分别为r=0.889，P<0.001和r=0.802，P<0.01）。当Ki-67＞3%时，第一组中锝（99m）Tc-（V）DMSA的L/B（晚期）比值显著高于Ki-67≤3%时（P=0.016），但在ER＞15%和≤15%之间差异不显著（P=0.732）。
UDH中锝（99m）Tc-（V）DMSA摄取与Ki-67表达相关。这可能有助于识别患有良性但高危乳腺病变且可能从化学预防中获益的女性。
