^99mTc(V)-DMSA与^99mTc-HYNIC-TOC显像诊断甲状腺髓样癌术后复发和转移价值的对比研究  

Comparison of ^(99m)Tc(V)-DMSA and ^(99m)Tc-HYNIC-TOC scintigraphy in detection of recurrent and metastatic medullary thyroid carcinoma

作　　者：李毅 潘禾戎[1,2,3,4] 许晓平 朱蓓玲[1,2,3,4] 杨忠毅 徐俊彦[1,2,3,4] 章英剑 LI Yi;PAN Herong;XU Xiaoping;ZHU Beiling;YANG Zhongyi;XU Junyan;ZHANG Yingjian(Department of Nuclear Medicine,Fudan University Shanghai Cancer Center Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Center for Biomedical Imaging,Fudan University,Shanghai 200032,China;Shanghai Proton and Heavy Ion Center,Shanghai 201315,China;Shanghai Engineering Research Center of Molecular Imaging Probes,Shanghai 200032,China)

机构地区：[1]复旦大学附属肿瘤医院核医学科,复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学生物医学影像研究中心,上海200032 [3]上海质子重离子医院核医学科,上海201315 [4]上海分子影像探针工程技术研究中心,上海200032

出　　处：《肿瘤影像学》2018年第3期150-156,共7页Oncoradiology

摘　　要：目的:该研究旨在比较^(99m)Tc(V)-DMSA与^(99m)Tc-HYNIC-TOC在定位甲状腺髓样癌(medullary thyroid carcinoma,MTC)术后复发和转移灶中的诊断价值。方法:回顾性分析2013年7月—2016年10月24例因术后复发或转移而来复旦大学附属肿瘤医院同期行^(99m)Tc(V)-DMSA(以下简称DMSA)和^(99m)Tc-HYNICTOC(以下简称TOC)显像的MTC患者。通过对比显像结果与手术病理或临床随访资料,来判断两种显像方法的应用价值。结果:基于患者的研究中,DMSA和TOC的灵敏度分别为62.5%和37.5%,差异有统计学意义(P=0.031);基于病灶(n=44)的研究中,前者灵敏度(93.2%)高于后者(43.2%)(P<0.000 1)。以降钙素水平500 pg/m L为界将病灶分成两组,当降钙素水平≤500 pg/m L(n=11)时,DMSA和TOC的灵敏度分别为81.8%和18.2%(P=0.016);当降钙素水平>500 pg/m L(n=33)时,两者灵敏度分别为97.0%和51.5%(P<0.000 1)。对于软组织病灶(n=36),DMSA灵敏度高于TOC(P<0.000 1);对于骨病灶(n=8),两者灵敏度差异无统计学意义(P=0.219)。结论:DMSA在定位MTC患者复发或转移灶中具有较高的灵敏度,优于TOC。Objective： To compare the clinical value of ^99mTc（V）-DMSA（DMSA for short） and ^99mTcHYNIC-TOC（TOC for short） in the detection of recurrent or metastatic medullary thyroid carcinoma（MTC）. Methods： From Jul. 2013 to Oct. 2016, 24 patients with suspicious recurrent or postoperative metastatic MTC, who underwent both DMSA and TOC imaging in our hospital, were enrolled in this retrospective study. The surgical pathology or clinical follow-up data were collected in order to compare the diagnostic values of these two methods.Results： In the patient-based analysis, the sensitivity of DMSA and TOC were 62.5% and 37.5%, respectively, the difference was statistically significant（P=0.031）. In the lesion-based analysis（n=44）, the sensitivity of DMSA（93.2%） was statistically higher than TOC（43.2%）（P〈0.000 1）. Using a cut-off calcitonin value of 500 pg/m L： lesions in patients with calcitonin lower than this value（n=11）, the sensitivity of DMSA and TOC were 81.8% and 18.2%, respectively（P=0.016）, lesions in patients with calcitonin exceeding this value（n=33）, they raised to 97.0% and 51.5%, respectively（P〈0.000 1）. In detecting soft tissue lesions（n=36）, DMSA had higher sensitivity than TOC（P〈0.000 1）. Whereas, there was no statistical difference in the sensitivity for bone lesions（n=8） between two methods（P=0.219）. Conclusion： DMSA has higher sensitivity than TOC in detecting the recurrence or metastatic medullary thyroid carcinoma.

关 键 词：降钙素 癌胚抗原 ^99MTC(V)-DMSA ^99mTc-HYNIC-TOC 甲状腺髓样癌 

分 类 号：R730.44[医药卫生—肿瘤]