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目的:探讨PET蛳CT在早期乳腺癌保乳微创治疗中的可行性及其临床意义。方法:选取2002年12月—2004年3月行PET蛳CT检查的乳腺肿瘤或腋窝肿物患者40例(包括1例男性患者),给予常规检查及PET蛳CT扫描,根据疾病性质及患者情况给予相应手术治疗,根据术后病理结果评价PET蛳CT对于原发肿瘤及转移灶诊断的准确性,及其判断腋窝淋巴结转移情况的可行性,并与SLNB或ALND进行比较。结果:PET蛳CT诊断原发肿瘤的敏感性、特异性、准确率为95.2 %、50 %、88 %;在切检术后病例中,PET蛳CT诊断肿瘤是否残留的敏感性、特异性及准确率为25 %、83.3 %、60 %;肿瘤病理大小与PET蛳CT诊断大小相关性最为显著(Pearson系数=0.786,P=0.000);以SLNB和/或ALND作为金标准,PET蛳CT诊断腋窝淋巴结状况的敏感性、特异性及准确率是72.2 %、94.4 %、83.3 %,诊断转移淋巴结数目与病理诊断数目的符合率为41.2 %。结论:PET蛳CT与原发肿瘤病理诊断基本符合,两者诊断原发肿瘤大小一致性最佳,PET蛳CT有望成为准确判断肿瘤范围的可靠方法;但对于腋窝淋巴结,PET蛳CT尚没有足够的敏感性及准确率成为SLNB以外的准确诊断腋窝淋巴结状况的方法。
Objective: To investigate the feasibility and clinical significance of PET 蛳 CT in breast-conserving and minimally invasive treatment of early breast cancer. Methods: 40 patients (including 1 male) with breast tumor or axillary mass who underwent PET 蛳 CT examination from December 2002 to March 2004 were selected for routine examination and PET 蛳 CT scan. According to the nature of the disease and the patient’s condition According to the postoperative pathological results, PET 蛳 CT was used to evaluate the accuracy of the diagnosis of primary tumor and metastasis, and its feasibility in judging the status of axillary lymph node metastasis. And compared with SLNB or ALND. Results: The sensitivity, specificity and accuracy of PET 蛳 CT in diagnosing primary tumor were 95.2%, 50% and 88% respectively. The sensitivity, specificity, and specificity of PET 蛳 CT in diagnosing the residual tumor in the cases after resection (Pearson coefficient = 0.786, P = 0.000). The diagnostic accuracy of PET 蛳 CT with SLNB and / or ALND as the gold standard was significantly higher than that with PET 蛳 CT The sensitivity, specificity and accuracy of axillary lymph node status were 72.2%, 94.4% and 83.3%, respectively. The coincidence rate of the number of diagnosed lymph nodes and the number of pathological diagnosis was 41.2%. Conclusion: PET 蛳 CT is basically consistent with primary tumor pathological diagnosis, both of which have the best consistency in diagnosis of primary tumor size. PET 蛳 CT is expected to be a reliable method to accurately determine the tumor range. However, PET 蛳 CT is not enough for axillary lymph nodes Sensitivity and accuracy become an accurate method of diagnosing axillary lymph nodes other than SLNB.