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目的探讨18-FDG-PET检查对于乳腺癌定性和淋巴结转移情况的诊断价值,评估其对于手术选择的参考意义。方法我科36例乳腺癌患者,在PET检查医师和患者双盲的情况下行18-FDG-PET,以术后病理检查结果作为金标准,对PET检查的漏诊率、误诊率、灵敏度、特异度等指标进行分析。结果对乳腺癌原发病灶的定性诊断误诊率为0,漏诊率为36.36%,灵敏度为63.63%,特异度为100%。对于肿瘤≤2cm的肿瘤漏诊率为41.67%。33例确诊乳腺癌患者淋巴结转移误诊率为18.75%,漏诊率为41.18%,灵敏度为58.82%,特异度为81.25%。结论PET对乳腺原发肿物定性诊断的误诊率低,特异性较好,但漏诊率较高,灵敏度尚待提高;对腋窝淋巴结定性诊断可为决定术式和取舍腋淋巴结清扫术提供有益的参考。对于不愿意接受针吸活检等有创伤性检查的患者,先行PET检查是比较理想的选择。
Objective To investigate the diagnostic value of 18-FDG-PET for the diagnosis of breast cancer and lymph node metastasis and to evaluate the reference value for the choice of surgery. Methods 36 patients with breast cancer in our department underwent 18-FDG-PET under the double-blind situation of PET examination physicians and patients. The postoperative pathological examination was used as the gold standard to evaluate the rate of misdiagnosis, misdiagnosis, sensitivity, specificity And other indicators for analysis. Results The rate of misdiagnosis of primary breast cancer was 0, the rate of missed diagnosis was 36.36%, the sensitivity was 63.63% and the specificity was 100%. Misdiagnosis rate was 41.67% for tumors ≤2 cm. The misdiagnosis rate of lymph node metastasis in diagnosed breast cancer patients was 18.75%, the missed diagnosis rate was 41.18%, the sensitivity was 58.82% and the specificity was 81.25%. Conclusions PET has a low misdiagnosis rate and good specificity for the qualitative diagnosis of primary breast masses, but its misdiagnosis rate is high and its sensitivity needs to be improved. The qualitative diagnosis of axillary lymph nodes can provide useful information for determining the surgical procedure and axillary lymph node dissection reference. For those who do not want to receive needle aspiration biopsy and other traumatic patients, the first PET examination is the ideal choice.