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目的 :评价 99m Tc- HL 91SPECT对于监测原发性肺癌治疗效果的作用。方法 :2 2例原发性肺癌患者静脉注射显像剂 99m Tc- HL9192 5 MBq后 4 h进行了 SPECT显像。所有患者均行两次 99m Tc- HL91SPECT显像 ,评价疗效前后各 1次。利用 4 h SPECT图像计算出肿瘤 /正常肺组织放射性比值 (T/ N)。依据治疗后 X线胸片或 CT扫描肿瘤大小的变化将病人分为两组 ,治疗有效组〔 R(+) ,n=9〕及无效组〔 R(- ) ,n=13〕。结果 :在 R(+)组 ,治疗后 T/ N值降低 ,从 2 .0 0± 0 .4 3降至 1.5 2± 0 .34(P<0 .0 1) ,而在 R(- )组 ,治疗后的 T/ N值反而增加 ,从 2 .2 6± 0 .2 9增至 2 .5 6± 0 .35 (P<0 .0 1) ,且 R(+)组降低的百分比显著高于 R(- )组降低的百分比 ,2 3.90 %± 7%与 - 14 .13%± 14 %(P<0 .0 1)。若以降低百分比≥ 10 %作为监测治疗有无反应的阈值 ,则 99m Tc- HL91SPECT评价疗效的灵敏度、特异性分别为 90 %、10 0 %。结论 :99m Tc- HL 91SPECT可以常规应用于原发性肺癌患者 ,从而评价疗效。
Objective: To evaluate the effect of 99m Tc-HL 91 SPECT on monitoring the therapeutic efficacy of primary lung cancer. Methods : Twenty-two patients with primary lung cancer underwent SPECT imaging 4 h after intravenous injection of imaging agent 99m Tc-HL9192 5 MBq. All patients underwent 99m Tc-HL91SPECT imaging twice before and after evaluation of efficacy. The tumor/normal lung tissue radioactivity ratio (T/N) was calculated using a 4 h SPECT image. Patients were divided into two groups based on changes in the size of X-rays or CT scans after treatment. The effective treatment group (R(+), n=9) and the ineffective group (R(-), n=13). RESULTS: In the R(+) group, the T/N decreased after treatment, from 2.00% to 0.44 to 1.52±0.34 (P < 0.01), while in R(-) In the group, the T/N after treatment increased but increased from 2.26 ± 0.29 to 2.56 ± 0.35 (P < 0.01), and the percentage of reduction in the R (+) group Significantly higher than the percentage reduction in the R(-) group, 2.90 % ± 7% and -14.13% ± 14% (P < 0.01). If the reduction percentage ≥ 10% is used as the threshold for monitoring the treatment response, the sensitivity and specificity of 99m Tc-HL91SPECT evaluation of efficacy are respectively 90% and 100%. Conclusion: 99m Tc-HL 91 SPECT can be routinely applied to primary lung cancer patients to evaluate the efficacy.