^(99m)Tc-MIBI全身显像及P糖蛋白预测中晚期非小细胞肺癌患者多药的耐药性  

An Investigation of ^(99m)Tc-MIBI Whole Body Scintigraphy and P-glycoprotein in the Prediction of Multiple Drug Resistance in the Mid-late Stage NSCLC Patients

作　　者：高勇强 刘超[2] 邓智勇[2] 程绘珺 李娇霞 郑贤东 陈婷[2] 吕娟[2] 周友俊[1] GAO Yong-qiang;LIU Chao;DENG Zhi-yong;CHENG Hui-jun;LI Jiao-xia;ZHENG Xian-dong;CHEN Ting;LV Juan;ZHOU You-jun(Dept.of Nuclear Medicine, the Affiliated Yan'an Hospital of Kunming Medical University,Yunnan Kunming 650051;Dept.of Nuclear Medicine,Yunnan Provincial Tumor Hospital Kunming,the Third Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650118,China)

机构地区：[1]昆明医科大学附属延安医院核医学科,云南昆明650051 [2]云南省肿瘤医院暨昆明医科大学第三附属医院核医学科,云南昆明650118

出　　处：《昆明医科大学学报》2018年第12期69-73,共5页Journal of Kunming Medical University

基　　金：云南省教育厅科学研究基金资助项目(2017zzx197);云南省肿瘤免疫防治研究重点实验室基金资助项目(2017DG004)

摘　　要：目的旨在中晚期非小细胞肺癌(Non-small-call lung cancer,NSCLC)患者半年随访期间利用^(99m) Tc-MIBI全身显像(whole body scintigraphy,WBS)及P糖蛋白(P-glycoprotein,PGP)预测其多药耐药(multiple drug resistance,MDR)。方法共入组57例中晚期NSCLC患者[男性39例,女性18例,平均年龄(59.5±14.7)岁],其中20例初诊患者未接受过任何治疗,37例复诊患者既往有过放化疗病史。所有患者初诊或治疗前均行PET/CT显像,原发病灶或转移病灶均由病理证实为NSCLC (腺癌31例,鳞癌26例)。患者开始治疗前进行一次WBS及PGP测定,疗效于半年之后复查PET/CT进行评价。当WBS检查显示至少一个部位存在非生理性放射性聚集时,则提示WBS阳性。当患者具有活性病灶,但WBS显示阴性,则提示存在MDR。结果WBS预测NSCLC患者发生MDR的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为:40%、73.7%、70.6%、43.8%及57.1%。而PGP对应的值分别为50%、52.6%、65.2%、38.5%及51.0%。WBS阴性患者发生MDR的危险性是WBS阳性患者的1.25倍(0.81～1.93)。结论 WBS和PGP预测中晚期NSCLC患者MDR的价值有限,WBS联合PGP方法以及更大样本的研究需要进一步深入探讨。Objectives To evaluate the^99mTcMIBI whole body scintigraphy(WBS)and P-glycoprotein(PGP)in the prediction of multiple drug resistance(MDR)in the mid-late stage NSCLC patients in a half-year follow-up.Methods 57 patients with mid-late stage NSCLC(39 male,18 female,with a mean age of 59.5±14.7 years)entered the study.20 patients had no previous history of treatment and 37 had a history of previous chemo-radiotherapy.All patients underwent PET/CT imaging before the initial diagnosis or treatment,and the primary lesion or metastasis was confirmed by pathology as NSCLC(31 adenocarcinoma,26 squamous cell carcinoma).WBS and measurements of PGP were performed before initialization of treatment and the response to treatment was assessed by PET/CT after six months.The WBS was considered positive when at least one area of non-physiologic increased activity was noted.The presence of MDR was indicated when the patient had active disease but the WBS was negative.Results For WBS,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy in NSCLC patients for the prediction of MDR were 40%、73.7%、70.6%、43.8%and 57.1%,respectively.Also the above values for PGP were 50%、52.6%、65.2%、38.5%and 51.0%,respectively.The risk of MDR in WBS negative patients was 1.25 times(0.60-1.72)higher than that in the WBS positive patients.Conclusion The value of WBS and PGP in the prediction of MDR in the mid-late stage NSCLC patients was limited.Studies using the method of WBS combined with PGP and including more samples may require further discussion.

关 键 词：^99MTC-MIBI 全身显像 多药耐药 P糖蛋白 

分 类 号：R655[医药卫生—外科学]