99mTc-depreotide受体显像在分化型甲状腺癌转移灶诊断中的临床应用

目的：探讨99mTc-depreotide受体显像在分化型甲状腺癌转移灶诊断中的临床应用价值。方法：67例接受131I治疗的分化型甲状腺癌（DTC）随访患者,以甲状腺球蛋白增高阈值〉10ng/ml为标准分为实验组（n=32）和对照组（n=35）,常规行131I全身扫描（WBS）,同时以99mTc-depreotide作为显像剂行肿瘤生长抑素受体显像。以核素显像感兴趣区（ROI）技术,测定肿瘤/非肿瘤（T/NT）比值,进行定量分析。比较99mTc-depreotide受体显像及131I全身显像在诊断甲状腺癌转移灶灵敏性、特异性、准确性的差异。结果：实验组99mTc-depreotide肿瘤受体显像和131I全身显像T/NT比值分别为4.45±0.44和2.14±0.51;对照组T/NT比值分别为1.13±0.21和1.42±0.16。两种方法的灵敏性、特异性、准确性分别为95.45%、50.00%、87.04%和81.82%、80.00%、81.48%。结论：99mTc-depreotide肿瘤受体显像可提高诊断分化型甲癌转移灶灵敏性,但特异性低于131I全身显像,99mTc-depreotide肿瘤受体显像可作为Tg、131I全身显像等分化型甲癌随访常规方法的有效补充。

The clinical application of 99mTc-depreotide somatostatin receptor imaging to diagnoze metastatic lesions of differentiated thyroid carcinoma

Objective：To evaluate application value of 99mTc-depreotide somatostatin receptor imaging in diagnosis of differentiated thyroid carcinoma metastatic lesions.Methods：Sixty-seven patients with differentiated thyroid cancer after 131I nuclear therapy were divided into experiment group and control group depend on Tg（the judgement threshold value 10ng/ml）.All lesions were confirmed by 131I-WBS and/or 99mTc-depreotide imaging or by other imaging modalities.The ratio of tumor to normal tissue（T/NT） was calculated over ROI to observe the radioactive uptake.All scintigraphically detected lesions were confirmed by histopathological analysis.Results：The T/N ratios were 2.14 ± 0.51 and 4.45 ± 0.44 in experiment group,1.13 ± 0.21 and 1.42 ± 0.16 in control group.The sensitivity,specificity and accuracy in differentiating malignant from benign lesion was 95.45%,50.00%,87.04% and 81.82%,80.00%,81.48%,respectively.Conclusion：99mTc-depreotide somatostatin receptor imaging are high sensitive method to diagnoze metastatic lesions of differentiated thyroid carcinoma.It can be used as a supplementary diagnostic method to other conventional method.