99mTc-MIBI SPECT compared with201TI SPECT for the detection of breast cancer and lymph node metastasis

A comparative study of²⁰¹Tl and^99mTc-methoxy-2 isobutyl isonitrile (^99mTc-MIBI) was performed in 39 breast tumors.²⁰¹Tl scintigraphy was carried out in 24 breast tumors and^99mTc-MIBI scintigraphy in 15. The sensitivity of²⁰¹Tl for malignant tumors was 100% (22/22), but specificity was 0% (0/2). On^99mTc-MIBI scintigraphy, the sensitivity for malignant tumors was 83.3% (10/l2) and specificity was 100% (3/3).^99mTc-MIBI might be more useful for the diagnosis of breast tumors, because the tumor/background ratio of^99mTc-MIBI was significantly higher than that of²⁰¹T1. In addition,²⁰¹Tl scintigraphy and^99mTc-MIBI scintigraphy showed the same degree of accuracy (93.3%) in detecting lymph node metastasis. Moreover, when either ultrasonography (US) with²⁰¹Tl or^99mTc-MIBI scintigraphy was positive for lymph node metastasis, the accuracy of detection became 94.4%. The combined use of ultrasonography and scintigraphy might improve the accuracy of diagnosis of lymph node metastasis.     

Use of 201Tl SPECT Imaging to Assess the Response to Therapy in Patients with High Grade Gliomas

Purpose. To assess the potential role of ²⁰¹Tl single photon emission tomography (201-Thallium SPECT) when compared to other imaging modalities in the evaluation of the response to therapy in high grade gliomas. Materials and methods. Twenty patients with histologically proved high grade glioma have been included: 15 with glioblastoma (GBM), 3 with anaplastic astrocytoma (AA) and 2 with anaplastic oligoastrocytoma (AOA). Patients were assessed by ²⁰¹Tl SPECT, computed tomography (CT) and magnetic resonance imaging (MRI) at (a) either at the moment of maximum response to first line chemotherapy, or after the completion of radiotherapy and chemotherapy if post-surgical residual disease was present, and (b) after the completion of second line chemotherapy if disease persisted, or either a relapse or disease progression was confirmed. Final response was evaluated according to the McDonald criteria, and by comparing SPECT, CT and MRI results. Results. According to the McDonald criteria, clinical response after first line chemotherapy was 5 partial response, 7 stable disease and 8 progressive disease. Evaluation by ²⁰¹Tl SPECT was in agreement with such criteria in nearly all patients (90%). MRI findings closely agreed with the clinical follow-up. CT findings clearly differed from those observed by SPECT and MRI. After second line therapy, 10 patients progressed, 3 had stable disease and 7 had partial response. ²⁰¹Tl SPECT agreed with the clinical status in 89% cases, whereas MRI and, specially CT, fared significantly lower. Conclusion. Compared to conventional neuroimaging, ²⁰¹Tl SPECT added valuable information in the assessment of the response to therapy in our patient population; whenever findings were not conclusive and in the case of disagreement between CT and MRI findings.     

Thallium-201SPECT assessment in the detection of recurrences of treated gliomas and ependymomas

Introduction The aim of this study was to establish the value of thalium-²⁰¹ single-photon emission computed tomography (²⁰¹Tl-SPECT) in the detection of recurrences in the follow-up of patients with treated primary neuroepithelial tumours. Material and methods Sixty-three²⁰¹Tl-SPECT were performed in 36 patients with glioma (12 males, mean age of 46±13 years). All patients underwent surgery and adjuvant radiotherapy (and some of them received chemotherapy). All patients were submitted to morphological neuroimaging techniques as well (and²⁰¹ Tl-SPECT). Mean follow-up was 18.3±14.6 months. Gold standard was based on clinical follow-up, therapeutical decisions (at least 4 months after²⁰¹Tl-SPECT) and imaging features. Results Sensitivity and specificity of²⁰¹Tl-SPECT to detect glioma recurrences were 90% and 100% respectively and 93% accuracy. Sensitivity and specificity for high grade tumours, were 100% respectively. Due to 4 false negatives, sensitivity and specificity for low grade gliomas were 78% and 100%. In the positive²⁰¹Tl-SPECT group of patients overall survival was 13.64% at the end of the study. The negative²⁰¹Tl-SPECT group had 84.62% overall survival at the end of the study (p=0.0003). Conclusions ²⁰¹Tl-SPECT is a valuable and noninvasive diagnostic procedure to detect recurrence or progression disease for treated gliomas and ependymomas.²⁰¹Tl-SPECT has a good correlation with short term prognosis with excellent diagnostic accuracy.     

磁共振成像联合质子磁共振波谱在脑膜瘤中的应用研究

目的探讨磁共振成像(MRI)和质子磁共振波谱(1H-MRS)对脑膜瘤的诊断价值.方法对98例脑膜瘤患者行常规MRI平扫和增强扫描,其中28例在瘤体中心区与健侧镜像位置行1H-MRS检查.结果 MRI平扫T1加权成像(T1WI)像有58.1%(61/105)表现为等信号,31.4%(33/105)为略低信号,10.5%(11/105)为混合信号;T2加权成像(T2WI)像有40.0%(42/105)表现为等信号,41. 0%(43/105)为高信号,10.5%(11/105)为略低信号,8.5%(9/105)为混合信号.注射钆-二乙烯三胺五乙酸(Gd-DTPA)后所有脑膜瘤患者肿瘤实质部分均有不同程度的强化.行1H-MRS检查的28例患者均表现为明显增高的胆碱(Cho)峰,无或者很低的N-乙酰天门冬氨酸(NAA)峰,肌酸(Cr)峰基本上没有变化.脑膜瘤病灶中心区的NAA、Cr、Cho、NAA/Cr、Cho/Cr、NAA/Cho分别为0.09±0.06、0.31±0.22、0.46±0.16、0.33±0.42、1.50±0.68、0.15±0.08,与健侧镜像位置比较,Cr无差异(P＞0.05),NAA、Cho、NAA/Cr、Cho/Cr、NAA/Cho差异均有统计学意义(P＜0.05).结论 MRI平扫和增强是诊断脑膜瘤的最主要方法,1H-MRS可作为很重要的补充.     

Imaging with F‐18 FDG PET is superior to Tl‐201 SPECT in the staging of non‐small cell lung cancer for radical radiation therapy*

Thallium‐201 (Tl‐201) single photon emission computed tomography (SPECT) is funded for evaluation of malignancy in Australia and may have utility for staging of non‐small cell lung cancer (NSCLC) if CT results are equivocal. Fluorine‐18 fluorodeoxyglucose (F‐18 FDG) positron emission tomography (PET) is superior to CT for staging NSCLC but is more expensive and less widely available than Tl‐201 SPECT. Therefore, these techniques were prospectively compared in 27 radical radiation therapy candidates. Patients were allocated a conventional, PET and Tl‐201 stage. Tumour to background ratios (TBR) were recorded for the primary on both techniques. Metastatic disease was confirmed by surgical pathology, serial imaging or clinical follow up. Tumour to background ratios were consistently higher for FDG PET than Tl‐201 SPECT (P < 0.0001). Positron emission tomography detected all known primary tumours but Tl‐201 failed to image four primary tumours (15%). In 10 of 18 cases of discordance between PET and Tl‐201 SPECT regarding stage, corroboration was available from pathology or disease progression. Positron emission tomography was shown to have a 100% positive predictive value, including all three patients with PET‐detected distant metastases (P = 0.002). Results indicate that PET is superior to Tl‐201 SPECT scanning in the staging of NSCLC for radical radiation therapy, and that the low sensitivity for detection of local and metastatic disease is likely to limit the clinical impact and cost‐effectiveness of this technique despite its lower cost.     

Evaluation of Early Response to SU101 Target-based Therapy in Patients with Recurrent Supratentorial Malignant Gliomas Using FDG PET and Gd-DTPA MRI

Changes in [¹⁸F]-2-fluoro-2-deoxyglucose (FDG) uptake and gadopentetate dimeglumine (Gd-DTPA) enhancement before and after the first course of treatment with a cytostatic agent SU101 (N-[(4-trifluoromethyl)-phenyl]-5-methylisoxazole-4-carboxamide, SUGEN) were assessed using positron emission tomography (PET) and magnetic resonance imaging (MRI) in a pilot study of 8 patients with recurrent supratentorial malignant gliomas. The localization and the volume of Gd-DTPA enhancement and FDG hypermetabolism were analyzed. PET and MRI studies were performed one week before and 7.6±3.7 weeks after administration of SU101. The ratios of mean tumor nobreak activity to mean contralateral white matter and ipsilateral cerebellar activity were calculated for tumor regions, and SUV values corrected to the subjects' body surface area and glucose level (SUVbsa^*glu) were calculated for non-tumor regions. Five patients had a substantial increase of tumor volume on both PET and MRI during the first course of SU101. PET and MRI showed roughly equivalent volume changes. Large tumor volume increases were associated with a short time to clinical progression. The metabolic change in the tumor following the first course of SU101 varied from patient to patient, ranging from a 31% reduction to a 43% increase in FDG uptake ratio. Changes in FDG uptake were not predictive of time to progression or survival. In 2 patients with marked clinical deterioration and rapid tumor growth, there were differences in localization of Gd-DTPA enhancement and FDG hypermetabolism suggesting that hypermetabolism beyond the area of contrast enhancement may be of value in predicting rapid progression of high-grade glioma. SU101 did not induce any appreciable changes in SUVbsa^*glu for non-tumor brain in 6 of 8 patients.     

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

The -1p/-19q genotype predicts chemosensitivity in oligodendroglial neoplasms, but some with intact 1p/19q also respond and not all with 1p/19q loss derive durable benefit from chemotherapy. We have evaluated the predictive and prognostic significance of pretherapy (201)Tl and (18)F-FDG SPECT and genotype in 38 primary and 10 recurrent oligodendroglial neoplasms following PCV chemotherapy. 1p/19q loss was seen in 8/15 OII, 6/15 OAII, 7/7 OIII, 3/11 OAIII and was associated with response (Fisher-Exact: P=0.000) and prolonged progression-free (log-rank: P=0.002) and overall survival (OS) (log-rank: P=0.0048). Response was unrelated to metabolism, with tumours with high or low metabolism showing response. Increased (18)F-FDG or (201)Tl uptake predicted shorter progression-free survival (PFS) in the series (log-rank: (201)Tl P=0.0097, (18)F-FDG P=0.0170) and in cases with or without the -1p/-19q genotype. Elevated metabolism was associated with shorter OS in cases with intact 1p/19q (log-rank: (18)F-FDG P=0.0077; (201)Tl P=0.0004) and shorter PFS in responders (log-rank: (18)F-FDG P=0.005; (201)Tl P=0.0132). (201)Tl uptake and 1p/19q loss were independent predictors of survival in multivariate analysis. In this initial study, (201)Tl and (18)F-FDG uptake did not predict response to PCV, but may be associated with poor survival following therapy irrespective of genotype. This may be clinically useful warranting further study.     

SPECT/CT与MRI对单椎体骨肿瘤的诊断价值比较

目的:探讨与比较单光子发射计算机断层成像术(SPECT)与磁共振成像(MRI)对单椎体骨肿瘤的诊断价值.方法:2014年8月到2018年6月选择在我院收治的经手术病理确诊的单椎体骨肿瘤患者54例,病理诊断为良性肿瘤38例(良性组),恶性肿瘤16例(恶性组).记录所有患者的SPECT/CT与MRI特征,然后判断诊断价值....     

Evaluation of brain tumor metabolism with [11C]choline PET and 1H-MRS

Background: The signal of choline containing compounds (Cho) in proton magnetic resonance spectroscopy (¹H-MRS) is elevated in brain tumors. [¹¹C]choline uptake as assessed using positron emission tomography (PET) has also been suggested to be higher in brain tumors than in the normal brain. We examined whether quantitative analysis of choline accumulation and content using these two novel techniques would be helpful in non-invasive, preoperative evaluation of suspected brain tumors and tumor malignancy grade. Methods: 12 patients with suspected brain tumor were studied using [¹¹C]choline PET, gadolinium enhanced 3-D magnetic resonance imaging and ¹H-MRS prior to diagnostic biopsy or resection. Eleven normal subjects served as control subjects for ¹H-MRS. Results: The concentrations of Cho and myoinositol (mI) were higher and the concentration of N-acetyl signal/group (NA) lower in brain tumors than in the corresponding regions of the normal brain. There were no significant differences in metabolite concentrations between low- and high-grade gliomas. In non-tumorous lesions Cho concentrations were lower and NA concentrations higher than in any of the gliomas. Enormously increased lipid peak differentiated lymphomas from all other lesions. The uptake of [¹¹C]choline at PET did not differ between low- and high-grade gliomas. The association between Cho concentration determined in ¹H-MRS and [¹¹C]choline uptake measured with PET was not significant. Conclusion: Both ¹H-MRS and [¹¹C]choline PET can be used to estimate proliferative activity of human brain tumors. These methods seem to be helpful in differential diagnosis between lymphomas, non-tumorous lesions and gliomas but are not superior to histopathological methods in estimation of tumor malignancy grade.     

Comparison of 68Ga-DOTATOC-PET/CT and PET/MRI hybrid systems in patients with cranial meningioma: Initial results

Background⁶⁸Ga-DOTATOC-PET/CT is a well-established method for detecting and targeting the volume definition of meningiomas prior to radiotherapy. Moreover, there is evidence that this method is able to detect meningiomas with higher sensitivity than the goldstandard MRI. Since the hybrid PET/MRI scanner became available in the past few years, the next stage of development could consequently evolve by evaluating the feasibility of a hybrid PET/MRI scanner using ⁶⁸Ga-DOTATOC for detecting meningiomas.MethodsFifteen patients received ⁶⁸Ga-DOTATOC-PET/CT (0.5 h post injection [p.i.]) followed by PET/MRI 2 hours p.i. Both investigations were analyzed separately and then compared with respect to image quality, detection of intracranial meningiomas, and radiotracer uptake values (RUVs). In addition, ratios between radiotracer uptake in meningiomas and pituitary glands were compared between both PET/CT and PET/MRI.ResultsOverall, 33 intracranial meningiomas were detected. All were visible with high contrast in both PET/CT and PET/MRI. ⁶⁸Ga-DOTATOC-PET/MRI provided flawless image quality without artefacts. Calculated RUV in meningiomas, as well as the ratios of RUVs in meningiomas to those of pituitary glands, were higher in PET/CT. As a result, meningiomas can be distinguished from pituitary glands better in early images.Conclusions⁶⁸Ga-DOTATOC-PET/MRI provided flawless image quality and presented an ideal combination of high sensitivity/specificity (PET) and the best possible morphological visualization of meningiomas (MRI). In addition, excellent detection of meningiomas is already possible at 0.5 hours p.i. Later images do not improve the distinction between pituitary gland and adjacent meningiomas. However, RUVs need to be carefully compared between both imaging modalities.     

宫颈癌放化疗联合热疗的疗效及MRI对其评价的临床价值

目的 探讨MRI影像学方法对放化疗联合热疗治疗宫颈癌的临床疗效的评价价值.方法 选取58例宫颈癌患者,随机分为联合组(29例)和对照组(29例).联合组采用放化疗联合热疗治疗,对照组采用单纯的放化疗治疗,2组疗程均为5～6周.评价2组治疗前后MRI成像及ADC值在宫颈癌放化疗联合热疗治疗后监测肿瘤变化的价值.结果 联合组和对照组的肿瘤缓解率分别为72.41％和61.72％;联合组、对照组患者治疗后ADC均值较之前均有所升高,且联合组ADC均值(1.99±0.28)高于对照组(1.54±0.25);P均＜0.05,数据具有统计学意义.结论 联合组治疗宫颈癌疗效优于对照组,MRI具有无辐射、无创伤等优点,能通过影像及ADC值检测肿瘤的生长及变化,在宫颈癌治疗的疗效评价中起着重要作用.     

常规MRI与1H-MRS结合鉴别高级别脑胶质瘤与单发性脑转移瘤

目的 探讨常规磁共振成像（MRI）与氢质子磁共振波谱（1H-MRS）相结合在高级别脑胶质瘤与单发性脑转移瘤中诊断及鉴别诊断的价值。方法 选取我院收治经手术病理组织学证实的高级别脑胶质瘤患者27例与单发性脑转移瘤患者21例,进行常规MRI及1H-MRS检查。分析比较常规MRI的影像表现特征及1H-MRS代谢产物［N-乙酰天门冬氨酸（NAA）、胆碱（Cho）和肌酸（Cr）］变化情况。结果 常规MRI显示仅病变部位和水肿程度在两者间存在差异（P＜0.05）。1H-MRS高级别脑胶质瘤与单发性脑转移瘤瘤体区Cho／NAA值比较差异有统计学意义（P＜0.05）,而NAA／Cr、Cho／Cr值比较差异无统计学意义（P＞0.05）;两者瘤周区Cho／Cr、Cho／NAA值比较差异均有统计学意义（P＜0.05）,而NAA／Cr值比较差异无统计学意义（P＞0.05）。结论 常规MRI与1H-MRS相结合使高级别脑胶质瘤与单发性脑转移瘤诊断及鉴别诊断的准确性得到进一步提高,具有较高的临床应用价值。     

SPECT骨显像联合CT和MRI在恶性肿瘤骨转移诊断中的临床价值

目的探讨单光子发射计算机断层成像术(SPECT)骨显像联合CT和MRI在恶性肿瘤骨转移诊断中的应用价值。方法选取2016年3月至2019年3月间北京市房山区第一医院收治的80例恶性肿瘤并发骨转移患者,均采用SPECT骨显像、CT和MRI检查,分析原发肿瘤骨转移灶区域分布及三种检测方式诊断骨转移瘤的效能。结果无明显骨痛症状者46例,有明显骨痛症状者34例。骨转移瘤发生部位依次为脊柱、肋骨、骨盆、胸部、四肢和颅骨。脊柱转移瘤中,好发部位依次为胸椎、腰椎、骶椎和颈椎。SPECT与CT相同扫描野内诊断出464处病灶,SPECT检出429处(92.5%),CT检出率361处(77.8%),两者比较,差异有统计学意义(P<0.05),在相同扫描野之外SPECT另检出143处病灶。SPECT与MRI相同扫描野内诊断出321处病灶,SPECT检出307处(95.6%),MRI检出265处(82.6%),两者比较,差异有统计学意义(P<0.05),在相同扫描野之外SPECT另检出286处病灶。CT与MRI相同扫描野内诊断出259处病灶,CT检出185处(71.4%),MRI检出248处(95.8%),两者比较,差异有统计学意义(P<0.05)。SPECT骨显像联合CT和MRI检查的灵敏度、特异性和准确度均高于单独使用SPECT骨显像、CT或MRI,差异均有统计学意义(均P<0.05)。结论SPECT可作为可疑骨转移瘤的首选筛查手段,联合CT和MRI能明确恶性肿瘤骨转移的区域分布情况,提高诊断的灵敏度、特异性及准确度,有较高的临床价值。     

A Phase I Study of High-dose BCNU,Etoposide and Escalating-dose Thiotepa (BTE) with Hematopoietic Progenitor Cell Support in Adults with Recurrent and High-risk Brain Tumors

This phase I dose-escalation study was performed to determine the tolerability of three-drug combination high-dose BCNU (B) (450 mg/m²), escalating-dose thiotepa (500–800 mg/m²) and etoposide (1200 mg/m²) in divided doses over four days in 22 adults with malignant primary brain tumors. Patients received G-CSF and hematopoeitic support with peripheral blood progenitor cells (PBPC) (n=18) or both PBPC and marrow (n=4). The maximum tolerated dose of thiotepa with acceptable toxicity was determined as 800 mg/m². The 100-day mortality rate was 9% (2/22). Grade III/IV toxicities included mucositis (71%), diarrhea (29%), nausea/vomiting (19%), and hepatic toxicity (14%). Neurological toxicities occurred in 24% and included seizures (two patients) and encephalopathy (three patients). Encephalopathy was transient in two patients and progressive in one patient. All patients had neutropenic fever. Median time to engraftment with absolute neutrophil count (ANC) >0.5×10⁹/l was 10 days (range 8–30 days). Platelet engraftment >20×10⁹/l occurred after 11 days (range 9–65 days). In the eighteen patients supported solely with PBPC, there was a significant inverse correlation between CD34⁺ dose and days to ANC (rho=–0.78, p=0.001) and platelet engraftment (rho=–0.76, p=0.002). Overall, 11% of evaluable patients (2/18) had a complete response to BTE. Median time to tumor progression (TTP) was 9 months, with an overall median survival of 17 months. BCNU (450 mg/m²), thiotepa (800 mg/m²) and etoposide (1200 mg/m²) in divided doses over four days is a tolerable combination HDC regimen, the efficacy of which warrants further investigation in adults with optimally resected chemoresponsive brain tumors.     

5-fluorouracil metabolism and cytotoxicity after pre-treatment with methotrexate or thymidine in human hypopharynx and colon carcinoma xenografts: a19F-nuclear magnetic resonance spectroscopy study in vivo

The metabolism of 5-fluorouracil (5-FU) was monitored non-invasively in two xenografts, a hypopharynx carcinoma and a colon carcinoma (CSM) by¹⁹F-magnetic resonance spectroscopy following an i. v. bolus injection of 130 mg kg^–1 5-FU. Both the level of fluoronucleotides (FNuc) and the tumour growth delay were significantly higher in the CSM colon carcinoma than in the hypopharynx carcinoma (both parameters,P<0.001). Administration of 100 mg kg^–1 methotrexate (MTX) at 15 h before treatment with 5-FU caused a significantly increased conversion of 5-FU to FNuc in both tumours (P<0.05) as compared with the application of 5-FU alone. However, only in the CSM tumour was a significantly increased growth delay (P<0.01) observed. Pre-treatment of both xenografts with 400 mg kg^–1 thymidine enhanced the conversion of 5-FU to FNuc in both tumours. In the CSM tumour this treatment modality caused a significantly (P<0.05) higher growth delay as compared with the results obtained with 5-FU alone, whereas in the hypopharynx carcinoma the additional application of thymidine caused no significant change in tumour growth. It is known that both thymidine and MTX can reduce the DNA-directed cytotoxicity of 5-FU, whereas the RNA-directed cytotoxicity is increased. It is concluded that the DNA-mediated toxicity may be more important in the hypopharynx carcinoma than in the CSM colon carcinoma. As a consequence, pre-treatment with MTX or thymidine enhances FNuc formation, although only in the CSM carcinoma is there an increased tumour growth delay. Thus, in the hypopharynx carcinoma the measurement of FNuc did not serve as a predictor for the treatment efficacy of the combined treatment modality. Pre-treatment with MTX did not influence the catabolism of 5-FU, whereas thymidine actually prolonged the half-life of 5-FU without -fluoro--alanine becoming detectable.     

Effects of Combination Chemotherapy with Biscoclaurine-derived Alkaloid (Cepharanthine) and Nimustine Hydrochloride on Malignant Glioma Cell Lines

In the treatment of malignant glioma, chemotherapy plays a critical role as do surgical resection and irradiation. Cepharanthine (CEP), a biscoclaurine-derived alkaloid, reportedly potentiates the effects of antitumor agents and induces apoptosis in some cancer cells. Here, we examined the effects of CEP, alone and in combination with nimustine hydrochloride (ACNU), on the in vitro proliferation of malignant glioma cells. The cell lines used were U87MG, U251MG, and T98G. At concentrations from 1 to 10g/ml, CEP-promoted cell proliferation somewhat; growth inhibition was noted at concentrations of 15g/ml and higher. Phase-contrast microscopy showed that cells tended to detach from the culture dishes and that cell density became sparse at the higher concentrations. DAPI fluorescence nuclear staining revealed condensation and fragmentation of nuclei, indicating the induction of apoptosis. To examine the cascade of apoptosis, the caspase inhibitors YVAD and DEVD were added. They inhibited CEP-induced apoptosis in U251MG cells (a p53-mutant cell line), but not in U87MG cells (a p53 wild-type cell line), suggesting that in CEP-induced apoptosis two possible cascades are in play. In combination with ACNU, the effects of the higher concentrations of CEP were enhanced.     

MRI identified prognostic features of tumors in distal sigmoid, rectosigmoid, and upper rectum: treatment with radiotherapy and chemotherapy

PURPOSE: Neoadjuvant therapy is traditionally reserved for locally advanced mid and low rectal cancers. In tumors above this level, the need for adjuvant treatment is based on poor histopathologic features, but this approach has potential disadvantages. The aim of this study was to determine whether magnetic resonance imaging (MRI) could accurately stage tumors of the distal sigmoid, rectosigmoid, and upper rectum and help direct preoperative treatment. MATERIALS AND METHODS: A total of 75 patients with distal sigmoid, rectosigmoid, and upper rectal tumors were assessed preoperatively by MRI. If tumor extended beyond the planned surgical resection plane, chemoradiotherapy was offered. RESULTS: Of the 75 patients, 57 (76%) underwent primary surgery. Agreement between the MRI prognosis and histopathologic findings was 84% (95% confidence interval [CI], 72.6-92.7%). The other 18 patients underwent neoadjuvant chemoradiotherapy for poor prognostic features with predicted surgical resection margin involvement. The histopathologic examination confirmed tumor downstaging in 9 of the 18 patients who underwent chemoradiotherapy. The 3-year survival rate in the good prognosis group (91%; 95% CI, 77.1-97.3%) was not significantly different from that of the chemoradiotherapy group (81.4%; 95% CI, 52.4-93.6%). The poor prognosis group undergoing primary surgery had significantly worse survival (62.2%; 95% CI, 30.3-82.8%, p < 0.03). CONCLUSION: Our findings indicate that tumors of the distal sigmoid, rectosigmoid, and upper rectum can be staged accurately using high spatial resolution MRI and that those with poor prognostic disease may benefit from preoperative therapy.     

太空舱全身热疗系统治疗恶性肿瘤的效果观察

目的 研究太空舱全身热疗系统(ET-SPACETM-I)对恶性肿瘤的治疗效果.方法 用ET-SPACETM-I对入选的68例患者进行94人次全身热化疗,比较了治疗前、后卡氏评分,疼痛缓解和病灶变化程度.结果 68例94人次的全身热化疗后,卡氏评分提高53例(78%),疼痛缓解情况59例(87%),部分缓解25例(37%),稳定 好转34例(50%),病变进展9例(13%).毒副反应最多见的是皮肤灼伤9/94(9.57%),最严重的是急性呼吸衰竭2/94(2.13%).结论 ET-SPACETM-I全身热疗系统在对恶性肿瘤患者的全身加热过程中,加热均匀平稳,温度监测灵敏,操作简单,控制系统精确、方便、安全、可靠,是肿瘤治疗领域里的一种新技术,值得推广应用.     

晚期恶性肿瘤患者化疗前后T细胞亚群变化的临床分析

目的 探讨恶性肿瘤患者化疗前后T细胞亚群的变化.方法采用流式细胞术分别对26例晚期恶性肿瘤患者化疗前和化疗后外周血T细胞及亚群进行检测.结果晚期恶性肿瘤患者化疗前后CD3+T细胞百分数分别为(71.35+ 16.82)%、(70.49+16.82)%,差异无统计学意义(P＞0.05);CD3+ CD4+比值分别为(31...