分化型甲状腺癌肺转移患者^(99m)Tc-MIBI显像与^(131)I治疗疗效及疾病进展的相关性研究

Correlation between ^(99m)Tc-MIBI Imaging and ^(131)I Therapy about Disease Progression in Patients with Lung Metastasis of Differentiated Thyroid Cancer

目的探讨分化型甲状腺癌(DTC)肺转移患者99m锝-甲氧基异丁基异腈(^(99m)Tc-MIBI)显像结果与放射性碘治疗后^(131)I全身显像结果的相关性,评估^(99m)Tc-MIBI显像结果对于评估DTC肺转移疾病进展的应用价值。方法搜集甲状腺癌肺转移患者120例,在初次进行^(131)I清除残余甲状腺组织半年后,行^(99m)Tc-MIBI显像,第二天服用治疗剂量的^(131)I(150~220 mCi),5天后行^(131)I全身显像,结合甲状腺球蛋白(Tg),比较^(99m)Tc-MIBI显像与^(131)I全身显像的结果,进一步探讨^(99m)Tc-MIBI显像对于放射性碘治疗后DTC肺转移患者疗效评估及疾病进展的应用价值。结果120例患者根据显像结果,将其分为4组:^(99m)Tc-MIBI显像阳性、^(131)I全身显像阳性组(A组,n=12);^(99m)Tc-MIBI显像阳性、^(131)I全身显像阴性组(B组,n=16);^(99m)Tc-MIBI显像阴性、^(131)I全身显像阳性组(C组,n=78);^(99m)Tc-MIBI显像阴性、^(131)I全身显像阴性组(D组,n=14)。Spearman秩和相关检验提示两种显像结果呈中度负相关,相关系数rs=-0.410(P<0.0001)。且^(99m)Tc-MIBI阳性的两组患者(A组与B组)其Tg水平显著高于^(99m)Tc-MIBI显像阴性、^(131)I全身显像阳性(C组)患者(P<0.05)。结论^(99m)Tc-MIBI显像可以部分预测放射性^(131)I碘治疗结果,且^(99m)Tc-MIBI显像阳性患者往往有着较高的Tg水平。

Objective To investigate the correlation between 99 mTc-MIBI imaging results and ^(131)I whole-body imaging results in patients with differentiated thyroid cancer(DTC)lung metastasis and to evaluate the application value of 99 mTc-MIBI imaging results in evaluating the disease progression of patients with lung metastasis of DTC.Methods A total of 120 patients with lung metastasis of thyroid cancer diagnosed were collected.After clearing the residual thyroid tissue for half a year,99 mTc-MIBI imaging was performed.The therapeutic dose of ^(131)I(150-220 mci)was taken the next day.^(131)I whole-body imaging was performed five days later.Combined with thyroglobulin(Tg),the results of 99 mTc-MIBI imaging and ^(131)I whole-body imaging were compared to further explore the efficacy and disease progress of 99 mTc-MIBI imaging in patients with DTC pulmonary metastasis after radioiodine therapy The application value of the exhibition.Results Imaging results from 120 patients were included in the study.According to the results of 99 mTc-MIBI imaging and ^(131)I whole-body imaging performed each time,the patients were divided into four groups:99 mTc-MIBI imaging positive group and ^(131)I imaging positive group(group A,n=12);99 mTc-MIBI imaging positive group and ^(131)I imaging negative group(group B,n=16);99 mTc-MIBI imaging negative group and ^(131)I imaging positive group(group C,n=78);The 99 mTc-MIBI imaging negative group and the ^(131)I imaging negative group(group D,n=14).Spearman rank correlation test was used to test the correlation between the two imaging results,and the results showed a moderate negative correlation,with the correlation coefficient rs=-0.410(P<0.0001).Moreover,we found that the Tg levels of patients in the two groups(group A and group B)with positive 99 mTc-MIBI imaging were significantly higher than those in the groups with negative 99 mTc-MIBI imaging and positive ^(131)I imaging(group C)(P<0.05).Conclusion 99 mTc-MIBI imaging can partially predict the outcome of radioiodine therapy,and patients with positive 99 mTc-MIBI imaging tend to have higher Tg levels.