协和医学杂志

2016, v.7(05) 327-333

[打印本页] [关闭]
本期目录(Current Issue) | 过刊浏览(Past Issue) | 高级检索(Advanced Search)

整合素受体显像~(99m)Tc-3PRGD2 SPECT/CT用于非小细胞肺癌诊断及淋巴结分期的价值
Integrin Receptor Imaging ~(99m)Tc-3PRGD2 SPECT/CT in Diagnosis and Lymph Node Staging of Non-Small Cell Lung Cancer

靳晓娜;梁乃新;王孟昭;贾兵;石希敏;李单青;李方;王凡;朱朝晖;
JIN Xiao-na;LIANG Nai-xin;WANG Meng-zhao;JIA Bing;SHI Xi-min;LI Shan-qing;LI Fang;WANG Fan;ZHU Zhao-hui;Department of Nuclear Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Thoracic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Respiratory Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union

摘要(Abstract):

目的通过与18F-FDG PET/CT比较,前瞻性评估整合素αvβ3受体显像~(99m)Tc-3PRGD2 SPECT/CT对非小细胞肺癌诊断及淋巴结分期的价值。方法前瞻性纳入2011年2月至2012年12月北京协和医院知情同意参与研究的65例肺占位病变患者。其中男41例,女24例,平均年龄(60±11)岁。患者在1周内分别行99mTc-3PRGD2 SPECT/CT和18FFDG PET/CT检查。完成病理诊断后,随访至死亡或随访至少2年。用受试者工作特征曲线、Z检验、卡方检验比较两种方法对肺内病灶及纵隔淋巴结的诊断效能。结果 53例患者共65个病灶经病理证实为非小细胞肺癌,12例患者共14个病灶诊断为良性病变。基于美国癌症联合委员会/国际抗癌联盟纵隔分区,248个区域有肿瘤转移淋巴结,56个区域有良性淋巴结。在诊断纵隔淋巴结转移方面,99mTc-3PRGD2 SPECT/CT特异性显著高于18F-FDG PET/CT(94.6%比75.0%,P=0.008),而两者的敏感性差异无统计学意义(88.3%比90.7%,P=0.557)。两种方法对肺内病变的诊断效能差异无统计学意义(Z=0.82,P=0.410)。结论整合素受体显像99mTc-3PRGD2 SPECT/CT在诊断淋巴结转移方面具有较高的特异性,可能弥补18F-FDG PET/CT的不足,在肺癌手术决策方面具有更大价值。
Objective To prospectively evaluate the value of integrin αvβ3receptor imaging approach basedon single photon emission computed tomography/computed tomography( SPECT/CT),using99mTc-3 PRGD2 as the tracer,in diagnosis and staging of non-small cell lung cancer( NSCLC) compared with18F-FDG positron emisson tomography/computed tomography( PET/CT). Methods From February 2011 to December 2012,65 patients with suspicious lung lesions were recruited with informed consent in Peking Union Medical College Hospital,including 41 males and 24 females,with a mean age of( 60 ± 11) years. The patients underwent both99 mTc-3 PRGD2 SPECT/CT and18F-FDG PET/CT within one week. After pathological diagnosis,all the patients were followed up until death or for at least two years. Receiver operating characteristic( ROC) curve,Z test,and Chi-square test were used to compare the diagnostic performance of the two imaging methods in assessing lung lesions and mediastinal lymph nodes. Results Sixty-five lung lesions in 53 patients were pathologically diagnosed as NSCLC,and 14 lung lesions in 12 patients were proved as benign.Based on the American Joint Committee on Cancer/Union for International Cancer Control( AJCC-UICC) standard,248 regions of lymph nodes had metastasis and 56 were negative regions.99mTc-3PRGD2 SPECT/CT was found to have higher specificity compared with18F-FDG PET/CT in the per-region diagnosis of lymph node metastasis( 94. 6% vs. 75. 0%,P = 0. 008),whereas the sensitivity of the two methods showed no statistically significant difference( 88. 3% vs. 90. 7%,P = 0. 557). There was no significant difference between the two methods in diagnostic performance for lung lesion( Z = 0. 82,P = 0. 410). Conclusion99mTc-3PRGD2 SPECT/CT shows high specificity in the diagnosis of lymph node metastasis from NSCLC,which may complement18F-FDG PET/CT in diagnosis and benefit surgical decision-making for patients with lung cancer.

关键词(KeyWords): 整合素αvβ3;单光子发射计算机断层成像术;非小细胞肺癌;淋巴结转移
integrin αvβ3;single photon emission computed tomography;non-small cell lung cancer;lymph node metastasis

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81171369);; 北京市科委“首都特色”临床专项(Z151100004015157);; 教育部博士点优秀青年教师科研基金(20131106120063)

作者(Author): 靳晓娜;梁乃新;王孟昭;贾兵;石希敏;李单青;李方;王凡;朱朝晖;
JIN Xiao-na;LIANG Nai-xin;WANG Meng-zhao;JIA Bing;SHI Xi-min;LI Shan-qing;LI Fang;WANG Fan;ZHU Zhao-hui;Department of Nuclear Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Thoracic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Respiratory Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union

Email:

DOI:

参考文献(References):

扩展功能
本文信息
服务与反馈
本文关键词相关文章
本文作者相关文章
中国知网
分享