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目的 探讨18 F-脱氧葡萄糖(FDG)PET/CT在乳腺癌术前诊断与TNM分期中的临床应用.方法 选取2015年5月至2018年5月沈阳军区总医院核医学科收治的75例疑似乳腺癌患者,采用PET/CT进行检查.分别由2位有5年以上工作经验的核医学医师诊断并进行TNM分期.计算PET/CT检查的阳性预测值、阴性预测值、灵敏度、特异度及准确性,并采用Kappa检验评估与病理结果的一致性.结果 PET/CT诊断乳腺癌的阳性预测值、阴性预测值、灵敏度、特异度、准确率分别为93.5％、61.5％、92.1％、66.7％、88.0％,检查结果与手术病理结果一致性一般,差异有统计学意义(Kappa=0.568,P<0.05).与病理结果比较,T分期中PET/CT正确分期49例,准确率为84.5％;N分期中正确分期48例,准确率为82.7％;M分期中正确分期57例,准确率为98.3％.结论 18 F-FDG PET/CT在乳腺癌的早期诊断与TNM分期体现较高的临床价值,尤其在检测淋巴结转移和远端转移方面具有重大意义.

Objective To investigate the clinical value of 18 F-FDG PET/CT in preoperative diag-nosis and TNM staging for breast cancer. Methods A retrospective study was performed on 75 cases of pa-tients with high likelihood of breast cancer that underwent 18 F-FDG PET/CT examination from May 2015 to May 2018. The images were diagnosed and TNM staging was performed by two nuclear medicine physicians with more than five years of relative experience. Statistical software was used to calculate the positive predic-tive value,negative predictive value,sensitivity,specificity and accuracy,Kappa test was used to assess the consistency between PET/CT and pathological results. Results The positive predictive value,negative pre-dictive value, sensitivity, specificity and accuracy of PET/CT diagnosis of breast cancer were 93. 5％, 61. 5％,92. 1％,66. 7％,and 88. 0％,respectively. There was a moderate consistency between PET/CT and pathology results (Kappa=0. 568,P<0. 05). The correct staging of PET/CT was 49 cases in T stage,with accuracy of 84. 5％,48 cases in N stage,with accuracy of 82. 7％,and 57 cases in M stage,with accuracy of 98. 3％. Conclusion The 18 F-FDG PET/CT was a non-invasive evaluation with high clinical value for ear-ly diagnosis and TNM staging for breast cancer,especially in detecting lymph node metastasis and distant metastasis.