^(99m)Tc-HL91肺癌乏氧显像临床价值研究

^(99m)Tc- HL91 Hypoxic Scintigraphy for Lung Cancer

【目的】探讨乏氧组织显像剂99mTc-HL91显像对肺癌诊断价值及与放射治疗前后肿瘤乏氧程度的改变。【方法】选取确诊的肺癌病例41例,非肺癌病例33例为实验组和对照组。实验组于放射治疗前后1,6h行99mTc-HL91肺癌乏氧显像并测定其T/NT比值,放疗后前后4h行CT+SPECT断层显像并测定T/NT比值;对照组行肺部1,6h99mTc-HL91肺癌乏氧显像。【结果】41例肺癌患者治疗前均可见病灶处放射性分布早期增加,血流灌注峰与邻近正常组织比较明显增加。治疗前1、6h平面显像T/NT值分别为1.2024±0.0745,1.4659±0.0820;治疗后1、6分别为1.0895±0.0553,1.2163±0.0694。治疗前后比较,P=0.000。对照组33例,1、6h平面显像双肺对应感兴趣区T/NT分别为0.978±0.055和0.980±0.030。肺癌组与对照组1h,6hT/NT值比较,差异有显著性,P=0.000。放疗后1、6h分别为1.0895±0.0553,1.2163±0.0694。治疗前后比较,P=0.000。放疗后1h,低度乏氧(1.0888<T/NT≤1.2024)18例,其疗效CR9例,PR8例,SD1例,PD0例;高度乏氧(T/NT>1.2024)23例,其疗效CR0例,PR18例,SD3例,PD2例。放疗后6h低度乏氧(1.0898<T/NT≤1.4659)22例,其疗效CR9例,PR12例,SD1例,PD0例;高度乏氧(T/NT>1.4659)19例,其疗效CR0例,PR14例,SD3例,PD2例。放疗疗效和乏氧程度分布有显著统计学差异(P<0.05)。【结论】99mTc-HL91能检测肺癌乏氧与否及其程度,可作为评价肺癌乏氧程度的一种辅助手段;肺癌患者放疗前后99mTc-HL91乏氧显像T/NT值分布有明显差异,其乏氧程度和放疗疗效关系密切,可作为肺癌放疗疗效预测的手段之一。

[Ohjective] To evaluate the etIicacy of ^99mTc-HL91 hypoxic imaging for lung cancer. [Methods] From January 2002 to October 2005, 41 patients with lung cancer were enrolled in the cfinical research and accepted hypoxic seintigraphy of ^99mTc- HL91 post- and after radiotherapy. The other 33 patients with non-lung cancer accepted hypoxic seintigraphy of ^99mTc- HL91 also. T/NT ratio also were ohtainod in 1, 4, and 6 hours after injecting ^99mTc- HLgl solution. [Results] In lung cancer group, radioactivity accumulation were present in all lung cancer patients. 1 hour and 6 hours before radiotherapy, the T/NT ratio were 1.2024±0.0745 and 1.4659±0.0820; 1 and 6 hour after radiotherapy, the T/NT ratio were 1.0895±0.0553 and 1.2163±0.0694. In non-lung cancer group, the T/NT ratio were 0.978±0.055 and 0.980±0.030. The two groups had statistical difference in 1 and 6 hour after injecting ^99mTc- HL91 solution. 1 and 6 hour after radiotherapy, the T/NT ratio were 1.0895±0.0553 and 1.2163±0.0694. In non-lung cancer group, the T/NT ratio were 0.978±0.055 and 0.980±0.030. There were statistical difference in 1 and 6 hours before and after injecting ^99mTc- HL91 solution. One hour after radiotherapy,18 cases showed low-hypoxic including CR 9 cases, PR 8 cases, SD 1 case, and PD 0 case; 23 cases showed high-hypoxic including CR 0 cases, PR 18 cases, SD 3 case, and PD 2 case. 6 hours after radiotherapy, 22 cases showed low-hypoxic including CR 9 cases, PR 12 cases, SD 1 case, and PD 0 case; 19 cases showed high -hypoxic including CR 0 cases, PR 14 cases, SD 3 case, and PD 2 case. [Conclusions] Lung cancer shows high sensibility to hypoxic cell.^99mTc- HL91 hypoxic scintigraphy for lung cancer is available and usefti. There was close relation between the degree of ^99mTc- HL91 hypoxic scintigraphy and the effects of radiotherapy for the patients with lung cancer.