肺肿瘤^(99)Tc^m-N(NOEt)_2SPECT显像研究

Clinical study of^(99)Tc^m-N(NOEt)_2 SPECT imaging in lung neoplasms

目的 探讨^(99)Tc^m-氮-二(N-乙基-N-乙氧基二硫代氨基甲酸盐)[N(NOEt)_2]SPECT显像诊断肺肿瘤的临床价值。方法 对38例临床疑肺肿瘤患者行^(99)Tc^m-N(NOEt)_2 SPECT显像,并与手术、病理检查结果对照。结果 38例疑肺肿瘤患者经病理检查或临床随访证实肺恶性肿瘤29例,肺良性肿瘤或病变9例。29例肺恶性肿瘤有31个病灶,^(99)Tc^m-N(NOEt)_2 SPECT显像示异常28个,正常3个;9例肺良性肿瘤或病变有9个病灶,显像示异常3个,正常6个。^(99)Tc^m-N(NOEt)_2 SPECT显像诊断肺恶性肿瘤的灵敏度为90.32％,特异性为66.67％,阳性预测值为90.32％,阴性预测值为66.67％,假阳性率为33.33％,假阴性率为9.68％,准确性为85.00％,阳性似然比为2.71,阴性似然比为0.15。9例肺良性肿瘤或病变患者病变部位与对侧对应正常肺组织放射性比值(T/N)为1.08±0.08,明显低于29例肺恶性肿瘤(1.30±0.19,t=3.38,P<0.01)。结论 ^(99)Tc^m-N(NOEt)_2 SPECT显像在肺肿瘤显像诊断中有一定的临床价值。

Objective To explore the clinical value of99Tcm-bis (N-ethoxy-iV-ethyl dithiocarbamato)-nitrido [N(NOEt)2 ] SPECT for detecting the lung neoplasm. Methods 99Tcm-N(NOEt)2 early planar, delay planar and SPECT imaging were performed on 38 patients suspected with lung neoplasm. The result was compared with pathological findings or clinical follow-up. Results Twenty-nine patients (31 lesions) were found be with primary malignancy of lung, whereas 9 cases (9 lesions) with benign diseases. Delayed 99 Tcm-N(NOEt)2 SPECT showed positive uptake in 28 of 31 malignant lesions and in 3 of 9 benign lesions. The sensitivity, specificity, positive predictive value, negative predictive value, false positive rate, false negative rate, accuracy, positive likelihood value, and negative likelihood value obtained with 99Tcm-N(NOEt)2 SPECT for malignant lung tumor were90.32%, 66.67%, 90.32%, 66.67%, 33.33%, 9.68%, 85.00%, 2.71 and 0.15, respectively. The T/N value of malignant nodules was 1.30 ± 0.19, the value of the benign lesions was 1.08± 0.08, the difference was significant (t = 3.38, P < 0.01). Conclusion This preliminary clinical study indicates that 99Tcm-N(NOEt)2 SPECT is of important value in detecting lung neoplasms.