99^Tc^m-HYNIC-octreotide显像与脑膜瘤病理分级的比较  

The prediction value to the grade of pathology in meningiomas with 99^Tc^m-HYNIC-octreotide imaging

作　　者：王胜军[1] 汪静[1] 邓敬兰[1] 张剑宁[2] 杨卫东[1] 曾瑾[1] 马福成[3] 王文勇[4] 

机构地区：[1]第四军医大学西京医院核医学科,西安710032 [2]第四军医大学西京医院神经外科2病区,西安710032 [3]第四军医大学西京医院病理科,西安710032 [4]第四军医大学病理教研室

出　　处：《中华核医学杂志》2009年第2期85-88,共4页Chinese Journal of Nuclear Medicine

基　　金：基金项目：国家自然科学基金（30570526）

摘　　要：目的探讨脑膜瘤99^Tc^m-联肼尼克酰胺（HYNIC）-奥曲肽（octreotide）生长抑素受体（SSTR）显像与脑膜瘤病理分级之间的关系。方法对30例脑膜瘤患者静脉注射740～925MBq99^Tc^m-HYNIC-octreotide，4h后行SPECT／CT头部断层显像，研究脑膜瘤和对侧相应部位放射性计数比（T／NT）值与病理级别的关系。对所有患者均行病理免疫组织荧光检测，观察SSTR2亚型（SSTR2）的表达情况及其与T／NT值的关系。采用SPSS11．0软件，组间T／NT值比较行t检验，T／NT值与病理级别、免疫荧光级别关系行Spearman相关分析。结果30例脑膜瘤均呈放射性中、高度浓聚，显像阳性率为100％。20例Ⅰ级脑膜瘤T／NT值为4．15±1．59，90％的可信区间为（1．53，6．77）；10例Ⅱ级脑膜瘤T／NT值为9．78±1．72，90％的可信区间为（6．95，12．61），两者的差异有统计学意义（t=3．396，P=0．002）。所有脑膜瘤均表达SSTR2。T／NT值与脑膜瘤病理级别、免疫荧光级别均呈正相关（r=0．824，0．851，P均〈0．01）。结论99^Tc^m-HYNIC-octreotide显像对于脑膜瘤的病理分级诊断有一定的临床价值。Objective Octreotide is a somatostatin analogy with a high affinity to somatostatin receptor subtype 2（SSTR2）. Meningiomas were shown to express SSTR2 above 80%. Convention imaging can be used to diagnose meningioma, but they can not reflect the pathological grade of meningioma. The aim of this study was to explore the relationship between 99^Tc^m-hydrazinonicotinamide （HYNIC）-octreotide imaging and the pathological grade of meningioma. Methods Thirty meningiomas were performed head transverse ima- ging of SSTR scintillography （SRS） with SPECT/CT after 4 h intravenous injection of 740- 925 MBq 99^Tc^m- HYNIC-octreotide. Furthermore, the relationships between tumor and corresponding region of opposite side （T/NT） and its grade of pathology were investigated. All the pathological tissues were checked with immunofluorescence. The t-test was used to compare T/NT ratios. Spearman analysis was used to analyze the relation of T/NT ratios and pathological grade or immunofluorescence. Results Totally 30 meningioma patients were included. The rate of positive imaging and expression of SSTR2 were 100% in all. The value in grade Ⅰ of meningioma was 4.15 ± 1.59 [90% confidence interval （CI） = 1.53 to 6.77 j and was 9.78 ±1.72 （90% CI = 6.95 to 12.61 ） in grade Ⅱ （ t = 3. 396, P = 0. 002 ）. Positive correlation relationship between T/NT and the level of immunofluoreseence was observed in both grade Ⅰ and Ⅱ meningioma （r = 0. 824, 0. 851 ; P 〈 0.01 ）. Conclusion 99^Tc^m-HYNIC-octreotide SPECT/CT imaging has potential to predict the pathology grade of meningioma.

关 键 词：脑膜瘤 放射性核素显像 HYNIC OCTREOTIDE 

分 类 号：R686[医药卫生—骨科学]