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作 者:李永军[1] 包丽华[1] 徐兆强[1] 李殿富[1] 王德杭[2] 卢凯华[3] 李田[4]
机构地区:[1]南京医科大学第一附属医院核医学科,江苏南京210029 [2]南京医科大学第一附属医院放射科,江苏南京210029 [3]南京医科大学第一附属医院肿瘤科,江苏南京210029 [4]南京市胸科医院
出 处:《实用放射学杂志》2006年第11期1391-1394,共4页Journal of Practical Radiology
基 金:南京医科大学科技发展基金资助项目(NY02037)
摘 要:目的探讨99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)乏氧显像预测局部晚期非小细胞肺癌(locally advanced non-sm all cell lung cancer,LANSCLC)对放疗敏感性的临床价值。方法对29例LANSCLC患者静脉注射99Tcm-HL91 1110MBq后进行1 h(早期)及4 h(延迟)SPECT断层显像,根据显像进行目测和半定量分析(T/N值),并按延迟显像T/N值将患者分为低摄取组及高摄取组。所有患者均接受常规分割放射治疗,对2组放疗近期疗效进行比较。结果99Tcm-HL91早期和延迟显像对LANSCLC患者乏氧诊断的灵敏度分别为75.9%(22/29)、100%(29/29),二者相比有显著差异(P=0.010)。半定量分析结果T/N值与不同病理类型、临床分期、病灶大小无明显关系(P>0.05)。低摄取组(T/N<2.15,n=17)放疗近期有效率76.5%(13/17)高于高摄取组(T/N≥2.15,n=12)的33.3%(4/12),比较有显著性差异(P=0.029)。结论99Tcm-HL91显像对LANSCLC乏氧诊断具有较高的灵敏度,并在预测其放疗近期效果方面具有一定的临床价值。Objective To investigate the clinical value of ^99Tc^m -4,9 -diaza-3,3,10,10 - tetrame thyldodecan -2,11 - dione dioxime ( HL91 ) imaging in predicting radiotherapeutic response to locally advanced non - small cell lung cancer( LANSCLC ) patients. Methods 29 patients with LANSCLC were included in the study. SPECT was performed in every patients at 1 h (early) and 4h(delayed) after intravenous injection 1110 MBq ^99Tc^m-HL91. The visual analysis and semi -quantitative analysis (T/N) of the early and delayed images were also performed. They were divided into 2 groups according to the T/N value of delayed images. All patients received conventional fractionated radiotheraphy, and the radiotheraphy efficacy in both groups was compared. Results The sensitivity of ^99Tc^m- HL91 imaging for hypoxic diagnosing of LANSCLC was 75.9% (22/29) in early imaging and 100% (29/29) in delayed imaging, there was significant difference ( P = 0. 010 ) . There were no obvious difference of T/N value in different pathological types and different clinical stages and different sizes of primary tumor ( P 〉 0.05 ). The radiotheraphic efficacy of the patients with low uptake ( T/N 〈 2.15, n = 17 ) was better than that of the patients with high uptake ( T/N 92.15, n = 12 ), that was significant difference ( 76.5% vs 33.3%, p = 0. 029 ). Conclusion ^99Tc^m- HL91 imaging is much sensitive for hypoxic diagnosis in LANSCLC, and is of important clinical value in predicting radiotheraphy efficacy.
关 键 词:肺 非小细胞肺癌 ^99TC^M-HL91 乏氧显像 放射治疗
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