鼻咽癌面颈联合野放疗对唾液腺功能影响的临床分析

目的 :利用放射性核素99mTcO4-动态显像唾液腺定量测定鼻咽癌面颈联合野放疗前、中、后唾液腺功能的变化并探讨与放疗剂量之间的关系。方法 :2 0 0 3年 2月 1日～ 2 0 0 3年 10月 3 1日 ,分别对 2 0例鼻咽癌面颈联合野放疗患者于放疗前、放疗至 10、3 6～ 40、70Gy时进行99mTcO4-动态显像定量测定其唾液腺(腮腺、颌下腺 )摄锝率 (UR)、泌锝率 (ER)变化 ,同时观察其口干程度进行临床分级。结果 :2 0例鼻咽癌面颈联合野放疗剂量为 10和3 6～ 40Gy时 ,其泌锝率明显低于放疗前 ,P <0 0 5 ,在放疗 70Gy时降到最低 ,P <0 0 1。与临床观察到的口干严重程度一致 ,而其摄锝率在 3 6～ 40Gy照射以前变化不明显 ,无统计学意义。结论 :鼻咽癌面颈联合野照射患者放疗前无明显唾液腺功能障碍 ,随着放疗剂量的增加 ,唾液腺功能明显下降 ,其ER较UR下降明显 ,在确保患者放疗疗效的同时 ,应尽可能提高放疗技术 ,减少唾液腺照射剂量和放疗体积 ,保护唾液腺功能 ,以提高患者的生活质量。     

提高乳腺癌早期诊断水平的研究

目的：评价育龄妇女乳腺疾病普查、乳腺钼靶摄片及^99mTc-MIBI核素显像在乳腺癌早期诊断中的价值，探索提高乳腺癌早期诊断的方法。方法：对徐州地区10万例育龄妇女进行乳腺疾病的普查，筛选出的乳腺癌高危人群及门诊就诊的乳腺疾{戎患者行乳腺钼靶摄片及^99mTc-MIB核素显像检查。结果：普查乳腺癌检出率为28．9／10万。乳腺钼靶摄片诊断乳腺癌的灵敏度为90．2％、特异性为31.4％。^99mTc-MIBI核素显像灵敏度为82．5％，特异性为90．2％。联合应用乳腺钼靶摄片与^99mTc-MIBI核素显像，对乳腺癌诊断的灵敏性为100％，特异性为99．3％。结论：育龄妇女乳腺疾病普查，结合乳腺钼靶摄片及^99mTc-MIBI核素显像可以明显提高乳腺癌的诊断率。     

99m Tc-HL91 "hot spot" imaging of mice bearing human carcinoma by gamma camera and the effects of tumor necrosis on imaging

Objective To evaluate the hypoxia-avid agent ^99m Tc-HL91 (^99m Tc labeled 4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime) as the tracer of tumor "hot spot" imaging and the influence of tumor necrosis on the image.
Methods After injection of ^99m Tc-HL91, 6 nude mice bearing human breast cancer MCF-7 and 18 nude mice bearing human pancreatic adenocarcinoma were subjected to gamma camera imaging, postmortem analysis, and autoradiography and imaging of tumor sections.
Results The image of tumor was identified 1 hour after injection of ^99m Tc-HL91.Images demonstrated gradually increased ^99m Tc-HL91 uptake in the tumor 1-12 hours after injection (P<0.05-0.001).Six hours after injection, the radioactivity ratios of tumor to thorax and tumor to head were higher than 2.1.Six hours after injection, the radioactivity ratios of tumor to brain, muscle, blood, heart, lung and kidney in pancreatic adenocarcinoma bearing nude mice were 101.0±114.7, 30.0±30.3, 19.9±21.9, 14.4±15.1, 3.71±2.41 and 0.46±0.26, respectively, and the radioactivity ratios in breast cancer MCF-7 bearing nude mice were close to these figures.The radioactivity of non-necrotic tumor was 3.77 times that of necrotic tumor.However, the radioactivity ratios of tumor to liver, intestine and stomach were lower than 1.3. Autoradiographs and images of tumor sections showed that the radioactivity was higher in the region of solid tumor than in the necrotic region.
Conclusion ^99m Tc-HL91 via gamma camera positively identifies regional tumor in nude mice bearing human cancer.^99m Tc-HL91 retention is lower in necrotic tumor than in non-necrotic tumor.The low radioactivity ratio of tumor to abdominal organs limits the application of ^99m Tc-HL 91 in detecting abdominal tumors.      

The comparison of dual phase Tc-99m MIBI and Tc-99m MDP scintimammography in the evaluation of breast masses: Preliminary report

The aim of this prospective study was to determine the diagnostic value of Tc-99m MDP scintimammography (SMG) for the detection of breast cancer in patients with breast masses and to compare the results with Tc-99m MIBI scintimammography. Twenty patients, categorized as suspicious, positive or benign for breast cancer according to the mammographic findings were included in the study. Dual phase Tc-99m MIBI and Tc-99m MDP SMG were performed in the prone lateral position within 5 days of each other. Although early and late Tc-99m MIBI SMG showed equal (90.4%) sensitivity, the specificity of late Tc-99m MIBI (87.5%) was found superior to early (62.5%) imaging. The overall sensitivity and specificity of early Tc-99m MDP SMG were 71.4% and 62.5%, respectively. Although late Tc-99m MDP imaging showed 100% specificity, its sensitivity was only 23.8%. In the patients with palpable masses, both early Tc-99m MDP and Tc-99m MIBI showed equal sensitivity (100%), but the sensitivity of early Tc-99m MIBI (37.5%) was found slightly higher than Tc-99m MDP (25.0%) for nonpalpable breast lesions. The sensitivity of Tc-99m MIBI and Tc-99m MDP SMG in detecting metastatic axillary involvement was 66.6% and 50%, respectively. High sensitivity and specificity together with its low cost, easy availability and the possibility of detecting bone metastases seems to make Tc-99m MDP a contributive agent in the evaluation of breast lesions as an alternative to Tc-99m MIBI.     

Technetium-99m labeling of a molecule bearing easily reducible groups

Chemical stability of the naphthol-azo dye Evans Blue (EB) was examined in the presence of acidic stannous chloride (SnCl₂), with a view to preparing an instant cold kit. EB was found to be reactive toward this reducing agent, yielding the metal-chelating molecule 1,7-diamino-8-naphthol-2,4-disulfonic acid at high acidity and high stannous concentrations. This reduction reaction was undesirable in the cold kit preparation. The conditions were determined where reduction was inhibited, at pH = 5.0 and with a mole ratio of EB to SnCl₂ = [10:1], effecting the facile preparation of stable cold kits. Successful ^99mTc-labeling of an EB cold kit using these conditions resulted in the desired product with 98% radiochemical purity. Based on the radiolabeling efficiencies of chosen model compounds, it was rationalized that ^99mTc metal predominantly coordinated with the 1-amino-8-hydroxy groups in the EB molecule to form ^99mTc-EB.     

~(153)Sm-EDTMP联合~(99m)Tc亚甲基二膦酸盐治疗多发性骨转移癌的临床观察

目的　评价 1 53钐 -乙二胺四亚甲基膦酸盐 (1 53Sm- EDTMP)与 99m Tc亚甲基二膦酸盐 (商品名云克 )联合应用治疗多发性骨转移癌的疗效。方法　各种骨转移癌 132例 ,随机分组治疗 ,第 1组 4 2例患者仅静脉注射 1 53Sm- EDTMP,1.0× 10 7Bq/ kg,第 2组 5 0例患者 1 53Sm- EDTMP联合 99m Tc亚甲基二膦酸盐治疗 ,1 53Sm- EDTMP用量不变 ,并与静脉注射 1 53Sm- EDTMP后的第 5天开始用 99m Tc亚甲基二膦酸盐连续 5 d。第 3组 4 0例患者静脉滴注博宁 ,10 d1个疗程。结果　第 1组镇痛有效率为 6 1% ,疼痛缓解持续时间平均 4周。第 2组联合用药组镇痛有效率达 80 % ,疼痛缓解持续时间平均 8周。第 3组镇痛有效率 4 2 % ,疼痛缓解持续时间平均 2周。 3组疗效有显著统计学意义 (P<0 .0 5 )。结论　不论 1 53Sm - EDTMP单独使用还是与 99m Tc亚甲基二膦酸盐联合用药都是治疗多发骨转移的有效止痛方法 ,相比之下 ,联合用药可明显提高镇痛效率。     

99mTc标记Laminin-YIGSR肿瘤小鼠模型显像的实验研究

目的探讨99mTc-YIGSR作为一种新型的肿瘤显像剂在埃氏腹水肿瘤受体显像中的应用价值。方法①制备99mTc-MAG3-YIGSR探针,以S-乙基-琥珀酰亚胺-巯乙苷肽(S-Acetly-NHS-MAG3)为螯合剂,将99mTc标记到层黏素多肽片断YIGSR上;②对肿瘤模型组及封闭模型组行99mTc-YIGSR生物学分布实验;③观察肿瘤模型组、炎症模型组及封闭模型组动物模型显像。结果①反相Sep-Pak C18柱层析结果表明,YIGSR可以很好地与S-Acetly-NHS-MAG3偶联,偶联物在室温及中性条件下可完成99mTc标记,标记率为62%,纯化后放射化学纯度>95%。室温放置1、2、4 h,放射化学纯度分别是91%,86%及81%。未与S-Acetly-NHS-MAG3偶联之YIGSR进行标记时,标记率为4%;②生物学分布结果显示,99mTc-YIGSR在小鼠血液内清除迅速,主要经肾脏排泄,其次为肝脏;③99mTc-YIGSR静脉注入肿瘤模型组小鼠体内后,15 min肿瘤部位有摄取,3 h摄取达高峰,肿瘤/对侧肢体比值为11.36,此后显像剂清除较为缓慢,8 h时下降至7.50。封闭模型组肿瘤细胞的摄取明显低下,肿瘤/对侧肢体比值是4.61(3 h)、0.89(8 h);炎症模型组中,炎症/对侧肢体比值是3.72(3 h)、1.29(8 h)。与炎症模型组及封闭模型组比较,肿瘤模型组3 h、8 h肿瘤/对侧肢体的比值明显增高(P<0.01)。结论通过螯合剂S-Acetly-NHS-MAG3可顺利完成层黏素多肽片段YIGSR的99mTc标记。99mTc-YIGSR用于肿瘤显像具有显像时间早,显像清晰,灵敏度高,特异性强,靶/非靶比值高等特点,是一种有发展前景的新型肿瘤受体显像剂。     

99mTc-MIBI乳腺亲肿瘤显像的临床应用

乳腺癌是妇女中常见的恶性肿瘤之一,其发病率仅次于宫颈癌。且发病率有逐年上升趋势,寻找一种能早期诊断的方法,能有效提高治愈率及延长寿命。目前临床常用的检查方法有X线钼靶、超声、MIR及针刺活检,虽然各有优点,但也存在着一定的不足之处。现99mTc-MIBI显像诊断乳腺癌已成为     

化疗增敏剂影响 P-糖蛋白依赖多药耐药性肿瘤细胞~(99)Tc~m-MIBI 摄取的实验研究(英文)

目的观察化疔增敏剂对多药耐药性(Multi-drug resistance,MDR)肿瘤细胞 P-糖蛋白(P-glycoprotein,P-gp)的影响及伴随~(99)Tc~m-MI-BI 摄取动力学的变化,以建立用~(99)Tc~m-MIBI 来评价化疗增敏剂效果的方法。方法 MDR 人乳腺癌细胞 MCF-7/Adr 37℃培养。(1)实验组和对照组细胞培养基中分别加入化疗增敏剂维拉帕米(10 μmol/L)和等体积培养液 DMEM。~(99)Tc~m-MIBI 与细胞共同孵育2 h 后收集细胞,测定放射性活度和 P-gp 表达水平。(2)维拉帕米(10 μmol/L)加入细胞培养基中,与细胞孵育若干时间后~(99)Tc~m-MIBI 加入细胞培养基中,与细胞一起培养2 h 后收集细胞。测定放射性活度和P-gp 表达水平。结果 (1)维拉帕米作用2h 后,细胞摄取~(99)Tc~m-MIBI 较对照组显著增加(t=2.33,P<0.05),但 P-gp 表达水平差异无显著性(P>0.05)。(2)肿瘤细胞摄取~(99)Tc~m-MIBI 随维拉帕米作用时间的延长而增加,各时间点 UR 差异有显著性(F=58.2,P<0.05),并且,VRP 作用时间在80 min 内时,肿瘤细胞摄取~(99)Tc~m-MIBI 与 P-gp 的表达水平无相关性(r=0.16,P>0.05),VRP 作用时间大于8 h时,肿瘤细胞摄取~(99)Tc~m-MIBI 与 P-gp 的表达水平呈负相关(r=-0.73,P<0.01)。结论化疗增敏剂能够影响 P-gp 过度表达所致 MDR 肿瘤细胞对~(99)Tc~m-MIBI 的摄取。     

Uptake of99mTc-tetrofosmin,99mTc-MIBI and201TI in malignant thymoma

99mTc-tetrofosmin, Thallium-201-chloride (201Tl) and 99mTc-MIBI imagings were performed in a patient with malignant thymoma. Tracer uptake in the primary tumor was demonstrated. The tumor-to-background ratios of planar and SPECT imagings were 1.60 and 1.98 for 99mTc-tetrofosmin, 1.12 and 2.09 for 201Tl, and 1.19 and 1.80 for 99mTc-MIBI, respectively. In another patient 99mTc-tetrofosmin and 201Tl imagings were performed. Not only the primary tumor but also the direct invasions and metastatic lesions (bone metastases) were clearly detected. The tumor-to-background ratios of planar and SPECT imagings were 2.31 and 2.78 for 99mTc-tetrofosmin and 2.45 and 3.58 for 201Tl, respectively. In 99mTc-tetrofosmin scintigraphy we acquired delayed images, and the tumor-to-background ratios of planar and SPECT delayed images were 1.20 and 1.86, the retention ratios were -1.11 and -0.92 and the retention indices were -48.1 and -33.1, respectively. Our preliminary results suggest that 99mTc-tetrofosmin is useful in detecting not only the primary tumor but also metastatic lesions from malignant thymoma.