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目的探讨99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)乏氧显像预测局部晚期非小细胞肺癌(locally advanced non-sm all cell lung cancer,LANSCLC)对放疗敏感性的临床价值。方法对29例LANSCLC患者静脉注射99Tcm-HL91 1110MBq后进行1 h(早期)及4 h(延迟)SPECT断层显像,根据显像进行目测和半定量分析(T/N值),并按延迟显像T/N值将患者分为低摄取组及高摄取组。所有患者均接受常规分割放射治疗,对2组放疗近期疗效进行比较。结果99Tcm-HL91早期和延迟显像对LANSCLC患者乏氧诊断的灵敏度分别为75.9%(22/29)、100%(29/29),二者相比有显著差异(P=0.010)。半定量分析结果T/N值与不同病理类型、临床分期、病灶大小无明显关系(P>0.05)。低摄取组(T/N<2.15,n=17)放疗近期有效率76.5%(13/17)高于高摄取组(T/N≥2.15,n=12)的33.3%(4/12),比较有显著性差异(P=0.029)。结论99Tcm-HL91显像对LANSCLC乏氧诊断具有较高的灵敏度,并在预测其放疗近期效果方面具有一定的临床价值。
Objective To investigate the predictive value of 99Tcm-4,9-diazine-3,3,10,10-tetramethyldodecane-2,11-dione oxime (HL91) hypoxia imaging for local advanced non-small cell lung cancer non-sm all cell lung cancer, LANSCLC) on the clinical value of radiosensitivity. Methods Twenty-nine patients with LANSCLC were intravenously injected with 1110MBq of 99Tcm-HL91 for 1 h (early) and 4 h (delayed) SPECT. Visual and semi-quantitative analysis (T / N) Like T / N value, patients were divided into low-intake group and high-intake group. All patients underwent routine fractionated radiotherapy to compare the short-term efficacy of the two groups of radiotherapy. Results The sensitivity of 99Tcm-HL91 early and delayed imaging in diagnosis of hypoxia in patients with LANSCLC were 75.9% (22/29) and 100% (29/29), respectively. There was significant difference between them (P = 0.010). Semi-quantitative analysis of T / N values and different pathological types, clinical stage, the size of the lesion had no significant relationship (P> 0.05). The effective rate of radiotherapy in low-dose group (T / N <2.15, n = 17) was 76.5% (13/17) higher than 33.3% (4/12) in high-dose group (T / N≥2.15, n = 12) There was a significant difference (P = 0.029). Conclusion 99Tcm-HL91 imaging has high sensitivity for the diagnosis of hypoxia in LANSCLC, and has certain clinical value in predicting the short-term radiotherapy effect.