The Study On Serum ICTP?TRACP5b And Bone Scintigraphy Semi-quantitative Analysis In Patients With Bone Metastasis Of Breast Cancer

Objective:Firstly,to explore the clinical value of detection of serum carboxyterminal telopeptide of type I collage?ICTP?and tartrate-resistant acid phosphatase 5b?TRACP5b?in the diagnosis of bone metastasis of breast cancer;Secondly,to evaluate the diagnostic value of single photon emission computed tomography?SPECT??single photon emission computed tomography/computed tomography?SPECT/CT?semi-quantitative analysis in benign and malignant lesions of breast cancer.Methods:1.From April to November 2018,58 patients with breast cancer were randomly selected.According to the imaging data and later follow-up,the patients were divided into two groups:bone metastasis group and non-bone metastasis group.In the group without bone metastasis,20 patients were treated with radiotherapy and chemotherapy,17 patients were treated with first operation?each patient collected serum before operation and after operation respectively?,8 patients were diagnosed as not receiving any treatment for the first time.There were 13 patients in bone metastasis group?all patients after radiotherapy and chemotherapy?and 20 healthy female sera collected in our hospital at the same time.A total of 95 serum samples were divided into 5 groups:the first confirmed untreated group?n=25?,the first operation group?n=17?,the postoperative radiotherapy group?n=20?,the bone metastasis group?n=13?and the healthy group?n=20?.The mean age was 52.3±13.8 years old.2.From July 2017 to November 2018,68 patients with breast cancer who were scheduled to undergo whole body bone scan in our department were randomly collected.All the patients showed abnormal concentration of imaging agents in the whole body bone scan images.Three hours after^99mTc-MDP 740¹110MBq was injected into the elbow vein,SPECT plane imaging was performed,and local SPECT/CT fusion imaging was performed if necessary.According to the imaging data and the follow-up results,the patients were divided into two groups:bone metastasis group and non-bone metastasis group.The area of interest is delineated on a planar image with an abnormal concentration of the image?T1?and Outline the region of interest outside of the skeleton by ROI technique.The radioactivity counts of the two areas were measured,and the?T₁-NT₁?/NT₁,was recorded as R1 and drawn three times,respectively.Take the mean value of the three measurements.Similarly,the area of interest?T2?is delineated on the transversal abnormal focus of the SPECT/CT fusion image?T1?and Outline the region of interest outside of the skeleton by ROI technique.The radioactivity counts of the two areas were measured,and the?T₂-NT₂?/NT₂,was recorded as R2 and drawn three times,respectively.Take the mean value of the three measurements.The differences of R1 and R2 between the two groups were compared by two-sample t-test.Results:1.Serum samples were collected from 75 patients with breast cancer and 20 healthy women.The serum ICTP,TRACP5b levels in the healthy group,the first confirmed untreated group,the first operation group,the postoperative radiotherapy group and the bone metastasis group were significantly higher than those in the control group?P<0.05?.There was significant difference in serum ICTP,TRACP5b level between bone metastasis group and healthy group and postoperative radiotherapy group?P<0.05?,and there was significant difference in serum ICTP,TRACP5b level between untreated group and healthy group for the first time?P<0.05?,but there was no significant difference between the two groups?P<0.05?.There was no significant difference in serum ICTP,TRACP5b levels between the first operation group and the first confirmed treatment group,and between the first operation group and the postoperative radiotherapy group?P>0.05?.There was a certain correlation between serum ICTP,TRACP5b levels?P=0.00,r=0.679?.2.The values of R1 and R2 in breast cancer patients with bone metastasis were higher than those in patients without bone metastasis on SPECT plane images and SPECT/CT fusion images?P<0.05?.For the differentiation of breast cancer with or without bone metastasis,the optimal threshold of R1 was 5.25?area under curve 0.734,sensitivity 74.5%,specificity 65.2%?.The optimal critical value of R2 was 16.10?area under curve 0.723,sensitivity 82.1%,specificity 60%?.Conclusions:1.Serum ICTP,TRACP5b has a certain value in the diagnosis of bone metastasis of breast cancer,and there is a certain correlation between the two,which have a synergistic effect on bone metastasis of breast cancer.2.SPECT plane imaging combined with ROI semi-quantitative method,R1?5.25?as the threshold for the diagnosis of bone aggregation is the best.SPECT/CT fusion imaging combined with ROI semi-quantitative method,R2?16.10?as the threshold for the diagnosis of skeletal foci is the best diagnostic efficacy.Aspect plane imaging ROI semi-quantitative method.SPECT/CT fusion imaging ROI semi-quantitative method in the diagnosis of breast cancer bone metastasis has a certain accuracy.