^99Tc^m-3P4-RGD2 SPECT显像对孤立性肺结节的诊断价值  

Diagnostic value of solitary pulmonary nodules using 99Tcm-3P4-RGD2 scintigraphy

作　　者：孙昱[1] 王任婕[2] 高识[2] 纪铁凤[2] 纪滨[2] 贾兵[3] 戚良晨[2] 马庆杰[2] 

机构地区：[1]吉林大学中日联谊医院影像科,长春130033 [2]吉林大学中日联谊医院核医学科,长春130033 [3]北京大学医学同位素研究中心

出　　处：《中华核医学与分子影像杂志》2013年第1期24-28,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家自然科学基金（81271606）;吉林省自然科学基金（201015185）;吉林省科技发展计划（200705323）

摘　　要：目的评价新的环状二聚体RGD^99Tc^m3P±RGD：SPECT显像定性和半定量分析法对SPN的诊断价值。方法选取21例CT上有SPN的患者进行前瞻性研究，其中男13例，女8例，年龄37～77（58±11）岁，给予（939±118）MBq^99Tc^m3P±RGD2后进行SPECT显像，以组织病理学诊断为“金标准”，比较CT、SPECT定性和T／NT分析的诊断效能，并绘制ROC曲线进行分析。采用免疫组织化学法分析部分标本整合素d，13，的表达。所有患者均签署知情同意书，放射性药物的应用通过医院独立伦理委员会和机构审查委员会审批。应用SPSS13．0软件对数据行两样本t检验和单因素方差分析。结果21例SPN病例中，15例（71％）为恶性，6例（29％）为良性。恶性SPN的平均T／NT比值比良性SPN高（1．87±0．39和1．41±0．65），但两者差异无统计学意义（t=2．01，P〉0．05）。CT、SPECT定性和半定量分析的灵敏度分别为80％（12／15）、100％（15／15）及100％（15／15），特异性均为4／6。用ROCAUC评估三者的诊断效能，分别为CT0．811（95％CI：58％～95％），SPECT为0．833（95％CI：61％～96％）及T／NT比值为0．844（95％C1：62％-96％），组间差异无统计学意义（F=0．83，P〉0．05）。免疫组织化学检查证实在”1rc”．3P4．RGD：SPECT显像病灶中有摄取的良恶性结节均表达a，β。结论SPECT定性和半定量分析法在”Tc”-3P±RGD，SPECT显像诊断SPN方面具有高灵敏度和一致性。Objective To investigate the value of 99 Tcm_HYNIC_ （ poly- （ ethylene glycol）, PEG） 4 - E （PEG±e （RGDfK））2 （99Tem-3P±RGD2） SPECT imaging in the diagnosis of SPN by visual and semiquantitative analysis. Methods Twenty-one patients （ 13 men, 8 women; age range 37 - 77 （58 ± 11 ） years） with SPN observed on CT were analyzed prospectively. All patients underwent SPECT imaging after administration of 99Tem-3P±RGD2 with a dose of （939 ± 118 ） MBq. The gold standard was based on the histopathologieal diagnosis of the surgical samples from all recruited patients. The diagnostic performance of CT, SPECT visual and semiquantitative analysis was compared and analyzed with ROC curves. Immunohistochemistry was performed in part of the samples to obtain the information of integrin ctvl53 expression. Informed consent was obtained from all patients. Application of a new radiopharmaceutical was permitted and approved by the local independent Ethics Committee and the Institutional Review Board of the China-Japan Union Hospital. One-way analysis of variance, two-sample t test were used with SPSS 13.0. Results Amongthe 21 SPN patients, 15 cases （71%） were diagnosed as malignant, and the other 6 （29%） were benign. T/NT ratio in malignant SPN was higher than that in benign SPN （1.87 ±0.39 vs 1.41 ±0.65）, but with no statistical significance （t = 2.01, P 〉 0.05 ）. The sensitivities for CT, SPECT visual and semiquantitative analysis were 80% （12/15）, 100% （15/15） and 100% （15/15） respectively, and the specificity were all 4/6. The AUC was 0. 811 （95% CI 58% -95% ） for CT, 0. 833 （95% CI 61% -96% ） for SPECT and 0.844 （95% CI 62% -96% ） for T/NT ratios, which showed no statistical significance （F =0.83, P 〉 0.05）. Immunohistochemistry confirmed ctv3 expression in both the malignant and benign nodules which had uptake of 99Tcm-3P±RGD2 in SPECT imaging. Conclusion SPECT visual and semiquantitative analysis with Tc-3P±RGD2 appears to have high sensitiv

关 键 词：肺肿瘤 锝 精氨酸 甘氨酸一天冬氨酸 体层摄影术 发射型计算机 单光子 x线计算机 

分 类 号：R730.44[医药卫生—肿瘤]