^(99)Tc^(m)-异腈脱氧氨基葡萄糖SPECT/CT在肺癌诊断中的临床研究  

Clinical Research on ^(99)Tc^(m)-isonitrile deoxyglucosamine single photon emission computed tomography/computed tomography for lung cancer diagnosis

作　　者：王勤奋[1] 秦将均[2] 许有忠 王平[1] 吴一清 邓镇生 李志伟[2] 陈丽娥 Qinfen Wang;Jiangjun Qin;Youzhong Xu;Ping Wang;Yiqing Wu;Zhengsheng Deng;Zhiwei Li;Li'e Chen(Department of Nuclear Medicine,Sanya Central Hospital(The Third People’s Hospital of Hainan Province),Sanya 572022,China;Department of Radiology,Sanya Central Hospital(The Third People’s Hospital of Hainan Province),Sanya 572022,China;Cardio Thoracic Surgery,Sanya Central Hospital(The Third People’s Hospital of Hainan Province),Sanya 572022,China;Department of Pathology,Sanya Central Hospital(The Third People’s Hospital of Hainan Province),Sanya 572022,China)

机构地区：[1]三亚中心医院(海南省第三人民医院)核医学科,海南省三亚市572022 [2]三亚中心医院(海南省第三人民医院)放射科,海南省三亚市572022 [3]三亚中心医院(海南省第三人民医院)心胸外科,海南省三亚市572022 [4]三亚中心医院(海南省第三人民医院)病理科,海南省三亚市572022

出　　处：《中国肿瘤临床》2021年第21期1125-1128,共4页Chinese Journal of Clinical Oncology

基　　金：海南省卫生计生行业科研项目(编号:19A200139)资助。

摘　　要：目的:研究^(99)Tc^(m)-异睛脱氧氨基葡萄糖(^(99)Tc^(m)-isonitrile deoxyglucosamine,^(99)Tc^(m)-CN5DG)SPECT/CT对肺癌诊断和鉴别诊断的价值。方法:收集2019年7月至2021年1月于三亚中心医院(海南省第三人民医院)前瞻性研究95例经过手术、组织活检病理确诊(92例)或治疗后临床影像随访证实(3例)的肺病损(共97个)患者,^(99)Tc^(m)-CN5DG SPECT/CT采用目测法结合半定量法判断良恶性,强化CT则据肺病损形态特征判断良恶性。分析^(99)Tc^(m)-CN5DG SPECT/CT、强化CT对肺病损的诊断效能。结果:97个肺病损中80个恶性、17个良性。良恶性肺病损的靶和非靶摄取比值(target to non-target,T/NT)[分别为(1.49±0.86)vs.(3.25±1.72)]差异有统计学意义(P<0.01)。^(99)Tc^(m)-CN5DG SPECT/CT诊断肺癌的灵敏度、特异性、准确性、阳性预测值、阴性预测值均高于强化CT(分别为97.5%、76.5%、93.8%、95.1%、86.7%vs.87.5%、41.2%、79.4%、87.7%、41.2%),其中灵敏度、准确性、阴性预测值的差异有统计学意义(均P<0.05)。^(99)Tc^(m)-CN5DG SPECT/CT提供了优于强化CT的纵膈淋巴结分期、肿瘤边界勾画等重要信息。结论:^(99)Tc^(m)-CN5DG SPECT/CT是使用简便、价格低廉、安全有效的肺癌诊断和鉴别诊断方法。Objective:To evaluate the clinical value of ^(99)Tc^(m)-isonitrile deoxyglucosamine single photon emission computed tomography/computed tomography(^(99)Tc^(m)-CN5DG SPECT/CT)for diagnosis and differential diagnosis of lung cancer.Methods:This prospective study included 95 patients with 97 confirmed lung lesions based on surgical(49 cases),tissue biopsy pathological examination(43 cases),or clinical imaging follow-up findings(three cases)in Sanya Central Hospital(The Third People’s Hospital of Hainan Province)from July 2019 to January 2021.Visual and semi-quantitative methods were performed using ^(99)Tc^(m)-CN5DG SPECT/CT to evaluate benign and malignant lesions,and enhanced CT was performed to determine benign and malignant lesions based on morphological characteristics of the lesions.The efficacies of ^(99)Tc^(m)-CN5DG SPECT/CT and enhanced CT in diagnosing lung lesions were then analyzed.Results:Among the 97 lung lesions,80 were malignant and 17 were benign.There was a significant difference in target to non-target(T/NT)values between benign and malignant lung lesions[(1.49±0.86)vs.(3.25±1.72);P<0.01].To diagnose lung cancer,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of ^(99)Tc^(m)-CN5DG SPECT/CT were higher than those of enhanced CT(97.5%,76.5%,93.8%,95.1%,and 86.7%,respectively vs.87.5%,41.2%,79.4%,87.7%,and 41.2%,respectively),indicating significant differences between the two modalities(P<0.05).Additionally,^(99)Tc^(m)-CN5DG SPECT/CT provided better information on mediastinal lymph node staging and tumor boundary delineation than enhanced CT.Conclusions:Thus,^(99)Tc^(m)-CN5DG SPECT/CT facilitates the diagnosis and differential diagnosis of lung cancer in a cost-effective,safe,and effective manner.

关 键 词：肺肿瘤 鉴别诊断 脱氧氨基葡萄糖 单光子发射型计算机断层显像 

分 类 号：R734.2[医药卫生—肿瘤]