99Tcm—MIBI显像预测小细胞肺癌化疗疗效的临床研究

99Tcm-MIBI SPECT in prediction of response to chemotherapy in patients with small cell lung cancer.

目的探讨99Tcm-MIBI显像预测小细胞肺癌化疗疗效的价值。方法53例小细胞肺癌患者根据胸部CT结果分为化疗有效组（完全缓解＋部分缓解）39例和无效组（病情稳定＋疾病进展）14例，于化疗前行99Tcm-MIBI肺显像，静脉注射99Tcm-MIBI740MBq后10—30min及2—3h分别行早期及延迟显像，分别获得早期相肿瘤与正常肺组织摄取比值（ER）和延迟相肿瘤／正常肺摄取比值（DR），计算滞留指数（RI）。采用t检验及秩和检验分析化疗有效组与化疗无效组ER、DR和RI之间的差别。结果99Tcm-MIBI显像结果中，化疗有效组的ER、DR分别为2．33±0．21、2．44±0．19，均显著高于化疗无效组的2．02±0．31、1．86±0．30，差异有统计学意义（t=-3．401、-6．724，P均〈0．05）。化疗有效组的RI中位值为5．31％，高于化疗无效组的-9．26％，差异有统计学意义（Z=-3．612，P〈0．05）。结论99Tcm-MIBI显像在预测小细胞肺癌化疗疗效方面具有重要的临床价值。

Objective To assess the prediction value of technetium-99m methoxyisobutylisonitrile （99 Tcm MIBI） for the effect of chemotherapy in small cell lung cancer （SCLC） patients. Methods Fifty-three patients with SCLC were divided into two groups according to the chest computed tomography （CT） examination, 39 patients in group A with complete or partial remission, and ld patients in groups B with stable or progressive status. 99 Tcm MIBI was performed before chemotherapy. Following i. v. administration of 740 MBq 99Tcm-MIBI, SPECT imagings at 10 -30 minutes （early） and 2 -3 hours （delayed） were performed to obtain the uptake ratio of early phase tumor/ normal lung tissue （ER） and the uptake ratio of delayed phase tumor/normal lung tissue （DR）. The retention index （RI） was calculated as （DR-ER）/ ER × 100%. The differences of ER, DR and RI between the two groups were tested through t-test and rank sum test. Results 99Tcm-MIBI uptake was significantly higher in group A than group B： 2.33（SD：0.21） vs 2.02（SD：0.31） for the early ratio （ER） （t= -3.401, P〈0. 05） and 2.44（SD：0.19） vs 1.86（SD ：0.30） for the delayed ratio （DR） （t = - 6. 724 ,P 〈 0. 05）. The median of RI in group A was significantly higher than that in group B （5.31% vs -9.26% ,P〈0.05）. Conclusions ER,DR and RI of 99Tcm-MIBI SPECT may be helpful in predicting the response to chemotherapy in patients with SCLC.