^(99m)Tc-Sandostatin生长抑素受体显像在肺癌诊治中的临床意义

The utility of ^(99m)Tc-Sandostatin somatostatin receptor imaging in the evaluation of lung cancer

目的 :探讨99mTc Sandostatin生长抑素受体显像对肺癌的诊断价值和治疗指导。 方法 :5 7例胸部CT疑肺癌患者。静脉注射99mTc Sandostatin (991.6± 187.5 9)MBq后 ,采用双探头可变角SPECT(MilleniumVG ,HAWKEYEGE)行平面及胸部断层显像 ,经重建后同时获得匹配的发射 透射图像 ,并获得融合图像。勾画肿块感兴趣区 (ROI)计算肿瘤和正常肺组织的放射性比值 (T/N) ,所有病灶均经病理及 (或 )其他检查证实。 结果 :5 7例99mTc Sandostatin显像诊断肺癌的灵敏度、特异性和准确性分别为 95 .7%、90 .0 %和 94 .7%。 4 5例患者检查真阳性 ,9例单个肺小结(SPN ,病理证实为良性病变 )真阴性 ,2例鳞癌假阴性 ,1例结核球假阳性。小细胞肺癌 (SCLC)、非小细胞肺癌(NSCLC)组T/N分别为 3.4 3± 0 .6 6和 2 .2 4± 0 .31。SCLC与NSCLC相比较 ,SCLC对99mTc Sandostatin的摄取明显高于NSCLC(t=4 .0 72 ,P <0 .0 5 )。 结论 :99mTc Sandostatin生长抑素受体显像是一种无创、安全、有效、简便的检查方法 ,对肺癌均有良好的诊断价值 。

Objective: To determine the noninvasive imaging efficacy of 99mTc-sandostatin scintigraphy for lung cancer. Methods: 57 consecutive patients with pulmonary nodules(PN) were studied with 99mTc-sandostatin scintigraphy.Planar imaging was obtained after injection of (991.6±187.59) MBq of 99mTc-sandostatin at 1.5-4 hour with GE Dual-head gamma camera(Millennium VG, Hawkeye ;General Electric Medical Systems) . SPECT images of the chest were performed at 4-6 h post injection. All scintigraphically detected lesions were confirmed by histopathological analysis and/or by other imaging modalities.Tumor to normal tissues ratios (T/N) were calculated . Results: Out of 57 patients ,47 were malignant tumors; 12 with small cell lung cancer (SCLC), 35 with non- small cell lung cancer (NSCLC). 10 had benign lesions. The sensitivity , specificity and accuracy of 99mTc-Sandostatin in detection of lung cancer were 95.7%, 90%, 94.7%, respectively. In two patients (pts) with pulmonary squamous cell cancer 99mTc-Sandostatin imaging was false negative. In 10 pts. with benign PN, 9 pts. was true negative, but one patient with tubercolama was false positive. T/N ratio was 3.43±0.66, 2.24±0.31 in SCLC and NSCLC respectively. The T/N ratio was higher in small cell lung cancer than NSCLC(t = 4.072 ,P < 0.05). Conclusion: 99mTc- Sandostatin scintigraphy is a promising noninvasive imaging method for lung cancer . However, further research is warranted.