肿瘤示踪剂^99mTc-PPM和^99mTc-MIBI在放射免疫导向手术中的应用

Radioimmunoguided surgery with labeled compound of 99mTc-PPM and 99mTc-MIBI for breast tumor

目的 探讨采用培普利欧霉素（99mTc-PPM）与甲氧基异丁基异晴（99mTc-MIBI）作为肿瘤示踪剂的放射免疫导向手术（RIGS）治疗乳腺肿瘤患者的可行性.方法 选择乳腺肿瘤患者50例,术前1h注射肿瘤示踪剂,其中注射99mTc-PPM32例,注射99Tc-MIBI 18例,手术切除肿瘤后用γ探针（GDP）探测肿瘤原发部位、周围组织与淋巴结,计算肿瘤与正常组织的放射性比值（T/NT）,再用γ井型探测仪探测切除组织的放射性,计算组织放射性物质摄取率,同时送病理检查.结果肿瘤部位的放射计数明显高于正常组织,肿瘤组织的T/NT值均＞4.0,阳性预测值为100%;GDP判定肿瘤淋巴结转移的敏感度为94%,特异度为93%,准确率为91%.结论 99mTc-PPM与99mTc-MIBI是良好的肿瘤示踪剂,GDP探测可以准确判断肿瘤的原发部位、侵及范围及淋巴结转移情况,RIGS可在治疗乳腺肿瘤领域推广应用.

Objective To evaluate the application of radioimmunoguided surgery with labeled compound of ^99mTc-PPM和^99mTc-MIBI in treatment of patients with breast tumor. Methods Fifty patients with breast tumor underwent mastectomy, lh before the surgery 32 patients were injected with ^99mTc-PPM和^99mTc-MIBI intravenously and 18 patients were injected with ^99mTc-PPM和^99mTc-MIBI. The removed tumors, surrounding tissue and lymph nodes were detected by gamma detecting probe （GDP） and the value of T/NT was calculated. Meanwhile, the radioactivity was detected by y well-type probe and the uptake rate of the radioactive substance was obtained followed by the pathology examination. Results The value of T/NT of all tumor tissue exceeded 4.0. The sensitivity, specificity and accurate rate of the GDP detection for metastatic lymph nodes were 94%, 93% and 91% respectively. Conclusion Radioimmunoguided surgery with ^99mTc-PPM和^99mTc-MIBI is feasible for treatment of patients with breast tumor.