摘要
目的:探讨99mTc-羟基亚甲基二磷酸(MDP)SPECT显像(MDPSI)诊断肺癌的临床价值及不同病理学特点的显像规律。方法:对63例经病理证实的肺肿瘤患者和10例正常对照进行早期(10min)MDPSI,用感兴趣区分析法计算肿瘤和正常肺组织的放射性比(T/NT),分析不同病理学特点与99mTc-MDP摄取的关系。结果:肺癌的99mTc-MDP摄取(2.36±0.56)明显高于良性病灶(1.44±0.47)和正常对照(0.98±0.12),t=5.26、7.70,P<0.01,以摄取比值>1.8为判断标准,MDPSI诊断肺癌的灵敏度、特异性和准确率分别为90.2%、90.9%和90.4%。鳞癌、腺癌、小细胞肺癌对99mTc-MDP摄取差异有显著性,周围型肺癌的摄取明显高于中央型,中高分化肺癌的摄取明显低于低分化癌,有骨转移的肺癌的99mTc-MDP摄取明显高于无骨转移者,<3cm、>3cm癌肿对99mTc-MDP摄取差异无显著性。结论:MDPSI对肺癌的鉴别诊断有较高的临床价值,肺癌对99mTc-MDP摄取与组织学类型、分化程度、肿瘤部位及骨转移有关,与肿瘤大小无明显关系。
Objective To evalute the clinical value of 99Tc-MDP SPECT imaging(MDPSI) in detection of lung neoplasms and assess the relationship between the pathologic features of the lesions and thier imaging characteristics . Methods The MDPSI was performed on 63 patients with pulmonary lesions confirmed by pathology and 10 normal subjects. SPECT data was acquired 10 minutes after injection of 1 100 MBq 99mTc-MDP. The tumor/non-tumor ratio(T/NT) was analyzed using region of interest analysis.The relationship between the uptake of the lesions and the pathologic features was analyzed.Results The T/NT of malignant lesions(2.36±0.56) was significantly higher than that of the benign (1.44±0.47) and the normal (0.98±0.12),t=5.26,7.70, P <0.01 .When the T/NT was 1.80 as a threshold,the sensitivity,specificity and accuracy of MDPSI for the lung neoplasms were 90.2% ,90.9% and 90.4% .The uptake of the lesions had significant difference among squamous cell carcinoma, adenocarcinoma and small cell carcinoma of the lung. The uptake of central lung cancer was much lower than the peripheral. The uptake of low differentiation lung carcinoma was much higher than that of the middle and the high. The uptake of lung cancer with skeletal metastases was much higher than that of lung cancer without skeletal metastases. The uptake of the lesions had no significant difference between < 3 cm and > 3 cm. Conclusions 99mTc-MDP is a good imaging agent and was useful in differentiating malignant lung neoplasms from bengin ones. The uptake of the lesions is correlated with pathohistologic types, differentiation degrees, tumor positions and skeletal metastases, and not significantly correlated with tumor sizes.
出处
《肿瘤防治杂志》
2003年第1期82-84,共3页
China Journal of Cancer Prevention and Treatment