^99Tc^m-octreotide显像在嗜铬细胞瘤定位诊断中的临床应用  

The clinical application of ^(99)Tc^m-octreotide scintigraphy in diagnosis of pheochromocytoma

作　　者：白永利[1] 王林[1] 董莉[1] 

机构地区：[1]陕西省人民医院,西安交通大学第三附属医院核医学科,陕西西安710068

出　　处：《现代肿瘤医学》2017年第23期3852-3854,共3页Journal of Modern Oncology

基　　金：陕西省科技厅自然科学基金项目(编号:2012JM4009)

摘　　要：目的:评估^(99)Tc^m-octreotide显像在嗜铬细胞瘤定位诊断中的临床应用价值。方法:21例术后经病理诊断为嗜铬细胞瘤患者为实验组。24例有高血压病史但血、尿中的儿茶酚胺,尿中的香草基苦杏仁酸含量均正常的患者为对照组。45例患者以^(131)I-MIBG(间碘苄胍)作为功能显像剂行SPECT定位诊断,同时以^(99)Tc^m-octreotide为显像剂行肿瘤生长抑素受体显像。以核素显像感兴趣区(ROI)技术,测定肿瘤/非肿瘤(T/NT)比值。比较^(99)Tc^m-octreotide肿瘤受体显像及^(131)I-MIBG全身显像在诊断嗜铬细胞瘤灵敏性、特异性、准确性等的差异。结果:实验组,^(99)Tc^m-octreotide显像和^(131)I-MIBG全身显像T/NT比值分别为(3.24±0.43)和(5.35±0.32),P<0.05有明显差异;对照组T/NT比值分别为(1.31±0.18)和(1.26±0.25),P>0.05无明显差异。实验组两种方法诊断嗜铬细胞瘤的灵敏性、特异性、准确性、阳性预测值、阴性预测值分别为83.33%、89.47%、86.48%、88.23%、85.00%和100%、84.21%、91.89%、85.71%、100%。结论:^(99)Tc^m-octreotide显像诊断嗜铬细胞瘤灵敏性、阴性预测值、准确性均低于^(131)I-MIBG全身显像,两种方法诊断嗜铬细胞瘤准确性无一致性,^(99)Tc^m-octreotide显像可作为嗜铬细胞瘤定位诊断方法的有效补充。Objective：To evaluate application value of ^99Tc^m -octreotide imaging in diagnosis of pheochromocyto- ma. Methods：The data of 21 patients were diagnosis for pheochromocytoma by histopathological analysis as the exper- imental group. 24 cases of hypertensive patients with urinary catecholamines, vanilla - based almond acid content were normal as control group. All lesions were confirmed by ^131I - MIBG and ^99Tc^m - octreotide imaging. The ratio of tumor to normal tissue（T/NT） was calculated over ROI to observe the radioactive uptake. Comparison of the differences between ^99Tc^m - oetreotide tumor receptor imaging and ^131I - MIBG imaging in the sensitivity,specificity, accuracy,positive predictive value, negative predictive value. Results ： The T/NT ratios were （ 3.24± 0.43 ） and （5.35 ± 0.32 ） in experiment group, respectively. （ 1.31 ± 0.18 ） and （ 1.26 ±0.25 ） in control group, respectively. In the experimental group, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the two methods for the diagnosis of pheochromocytoma were 83.33% ,89.47% ,86.48% ,88.23% ,85.00% and 100% ,84.21% , 91.89% , 85.71% , 100% , respectively. Conclusion：^99Tc^m - octreotide imaging sensitivity, accuracy and negative predictive value were lower than ^131I -MIBG imaging in diagnosis of pheochromocytoma, but ^99Tc^m -octreotide scin- tigraphy can be used as an effective complement on pheochromocytoma by conventional methods.

关 键 词：嗜铬细胞瘤 ^99Tcm-奥曲肽 ^131I-间碘苄胍 

分 类 号：R730.44[医药卫生—肿瘤]