简易的血清唾液酸动态监测在肺癌诊断中的应用价值

近年来有文献报道,血清唾液酸含量增高与恶性肿瘤相关;但血清唾液酸的传统测定方法繁琐,非一般实验室能开展,限制了它的广泛应用。F_(8836)化学比色法的吸光强度和血清唾液酸浓度呈良好的线性关系(γ=0.992)。我们采用F_(8836)化学比色法对肺癌和呼吸系常     

F—8836化学比色法诊断肺癌和肺结核球的临床应用

目前诊断肺癌尚缺乏简便有效的生化方法,F—8836化学比色法的吸光度检测肺癌与鉴别肺结核球方法简便、快速、准确性高、经济实用。     

骨骼和软组织肿瘤^18F—FDG PET的应用进展

^18F—FDG(1^18F-氟代脱氧葡萄糖)PET在肿瘤学领域已经得到了深入研究和广泛应用，尽管有关骨与软组织肿瘤的研究报告相对较少，但是近年来陆续发表的有关文献内容已涉及骨与软组织肿瘤病变良恶性鉴别、肿瘤恶性程度判断、治疗反应监测、肿瘤复发评价和骨转移肿瘤探测等诸多方面。     

偏侧帕金森病患者葡萄糖代谢与多巴胺转运蛋白PET显像

目的 评价葡萄糖代谢与多巴胺转运蛋白PET显像在偏侧帕金森病(PD)患者诊断中的价值。方法 正常对照组16例。偏侧PD患者34例，Hoehn—YahrⅠ～Ⅱ级。其中16例偏侧(右侧肢体)PD患者进行^18F—脱氧葡萄糖(FDG)PET显像，18例偏侧(右侧或左侧)PD患者进行^18F-N—(3—氟丙基)—2β—甲酯基—3β—(4′—碘苯基)去甲基托烷(FP—β—CIT)显像，6例患者同时进行两种显像。静脉注射^18F—FDG 185～259MBq 30min后进行脑三维采集，结果应用感兴趣区(ROI)半定量分析和统计参数地图(SPM)分析。^18F—FP—β—CIT显像于注射后2～3h进行，计算(各ROI计数—小脑计数）小脑计数比值。结果 PD组与对照组比较，患侧肢体对侧基底节葡萄糖代谢减低，但差异无显著性。SPM分析结果示，PD患者与对照组比较，葡萄糖代谢减低位于左侧前额叶、中额叶、下额叶及左侧中颞叶，而摄取增加区域除双侧额叶中央前回、双侧顶叶楔前叶、左侧枕叶外，还累及左侧丘脑。偏侧PD患者豆状核后部^18F—FP—β—CIT摄取显著减低，且不仅见于症状对侧豆状核，同侧豆状核后部也可见摄取减低。结论 ^18F—FDG PET显像对PD的早期诊断无特异性。^18F—FP—β—CIT可早期发现PD纹状体多巴胺转运蛋白的变化，有助于PD的早期诊断和鉴别诊断；与^18F—FDG PET显像结合，可显示大脑皮层的葡萄糖代谢变化。     

PETICT显像淋巴瘤病灶^18F—FDG摄取程度与肿瘤增殖性抗原Ki-67相关性研究

目的：通过对比50例不同病理亚型的淋巴瘤肿瘤增殖性抗原Ki-67表达水平与^18F—FDGPET显像病灶^18F—FDG浓聚程度来探讨两者之间相关性。方法：收集50例经病理及免疫组化证实的淋巴瘤病例,每个病例均有酶标肿瘤增殖性抗原Ki-67染色免疫组化报告,病理检查前或后常规行PET／CT检查。病理分型均采用WHO分类标准,并对非霍奇金淋巴瘤例按WF分类标准对其进行大小细胞类型归类。Ki-67酶标染色结果统一采用分级方法：核抗原染色阳性细胞百分数为0～5％,表示为微弱阳性（＋／-）;百分数为5％～20％,表示为弱阳性（＋）;百分数为20％～50％,表示为中阳性（＋＋）;百分数大于50％,表示为强阳性（＋＋＋）。PET／CT影像上,病灶^18F—FDG摄取程度采用半定量分析方法,计算出病灶平均标准化摄取值SUV（SUVave）。利用统计软件（SPSS13．0）计算不同病理亚型的病灶^18F—FDG摄取值（以^-x±s表示）,并对大、小细胞类型淋巴瘤的FDG摄取值差异显著性行t检验;对所有病灶Ki-67表达水平与^18F—FDG摄取程度两者之间采用Spearman方法进行相关性分析。结果：大细胞来源的淋巴瘤^18F—FDG摄取值远高于小细胞来源的淋巴瘤^18F—FDG摄取值,特别是B系大小细胞不同类型淋巴瘤,其^18F—FDG摄取值差异性更显著;Ki-67表达水平同结性与结外病灶^18F—FDG摄取值两者存在显著相关性,r值分别为0．750和0．843。结论：反映肿瘤增殖活性的Ki-67与淋巴瘤病灶^18F—FDG摄取程度有明显关系,Ki-67表达程度较高的大细胞性进展性淋巴瘤．其病灶^18F—FDG摄取值很高,而Ki-67表达程度较低的小细胞性低度恶性淋巴瘤,其^18F—FDG摄取值较低。     

西宁地区234例C—反应蛋白测定结果分析

采用上海市医药化工研究所提供的C—反应蛋白胶乳试剂,对健康人80例和各类疾病患者154例,进行了C—反应蛋白含量测定。154例各类疾病患者C—反应蛋白测定结果表明,急性炎症、心肌梗塞、肿瘤、败血症、风湿热、发热待查、化脓性感染时升高最明显,其次为类风湿性关节炎、心肌炎、高血压、贫血、乙型肝炎等。     

18F-FP-β-CIT PET脑显像在早期诊断帕金森病中的意义

目的 探讨多巴胺转运蛋白(DAT)PET显像在早期诊断帕金森病(PD)及评估其严重度中的意义。方法 以^18F—N—(3—氟丙基)—2β—甲酯基—3β—(4′—碘苯基)去甲基托烷(FP—β—CIT)为显像剂，对4例正常对照者、21例早期PD和10例晚期PD患者基底节区DAT进行PET显像，比较3组间基底节不同组成区DAT的差异，并判断其与临床严重程度的相关性。结果 在尾状核、前壳核、后壳核区，早期PD组的DAT均显著降低，分别降至对照组相应部位的71．8％、43．8％及23．6％，起病肢体对侧基底节DAT显著低于起病肢体同侧基底节DAT，早期偏侧PD患者起病肢体同侧(亚临床)基底节DAT显著低于对照者；晚期PD组则分别降至对照组的51．9％、31．8％及15．8％。这些区域的DAT与统一帕金森病评定量表(UPDRS)运动评分呈显著负相关，r分别为-0．423、-0.421、-0．532。结论 ^18F-FP—β—CIT PET显俊右助于PD的早期诊断及评估其严重度。     

多巴胺转运蛋白显像剂18F-FP-β-CIT制备与分布

目的　探讨简易制备和纯化多巴胺转运蛋白 (DAT)显像剂1 8F N (3 氟丙基 ) 2 β 甲酯基 3β (4′ 碘苯基 )去甲基托烷 (1 8F FP β CIT)的方法 ,进行大鼠脑内分布研究。方法　采用一步法标记 ,在氨基聚醚 (Kryptofix 2 2 2 )催化下 ,标记前体化合物N 3 (甲磺酰氧基丙基 ) 2 β 甲酯基 3β (4 碘苯基 )去甲基托烷 (MsOP CIT)直接与K1 8F在乙腈溶液中反应 ,生成1 8F FP β CIT ,用Sep PakSiO2 小柱分离纯化。大鼠给药后于不同时间处死 ,分离脑组织 ,分别称重后测定放射性计数。结果　1 8F FP β CIT总放化产率约为 10 % ,放化纯 >95 % ,纯化无需制备型高效液相色谱。总合成时间为 6 0～ 80min。药物能迅速被脑组织摄取 ,后不断清除 ,5和 180min时全脑摄取量 (%ID)分别为 1.4 9和 0 .17。纹状体放射性摄取大于其他区域 ,其与小脑的比值在 5、30、6 0、12 0和 180min时分别为 1.75、3.38、3.73、3.71和 3.2 0。结论　一步法可简便制得1 8F FP β CIT。     

18F-FDG hPET/CT显像在腹部消化系肿瘤的应用

目的 评价^18F-脱氧葡萄糖(FDG)符合线路显像结合图像融合(hPET/CT)探测可疑腹部消化系恶性肿瘤或肿瘤复发的临床价值。方法 对51例临床怀疑为腹部消化系恶性肿瘤或肿瘤复发患者行^18F-FDG符合线路显像，经迭代法处理和重建，获得经检查衰减校正后的断层图像和融合图像，以目测双盲阅片进行诊断分析，并与手术病理检查或CT和(或）MRI、临床随访作出的最后诊断结果进行对比。结果 ^18F—FDG符合线路显像对腹部消化系肿瘤诊断的灵敏度、特异性和准确性分别为94．1％，76．5％和88．2％；对结直肠癌复发的诊断灵敏度为94．1％，特异性为83．3％，准确性为91．3％。结论 ^18F—FDG符合线路显像对腹部消化系恶性肿瘤或肿瘤复发的诊断具有较高的灵敏度和准确性。     

兔动脉粥样硬化时红细胞及血清唾液酸含量的改变

用食饵性高血脂及食饵性高血脂加免疫性动脉内皮损伤的方法建立兔动脉粥样硬化模型，观察到随着动脉粥样硬化病变发生，红细胞膜唾液酸含量降低而血清唾液酸含量增高，与对照组比较均有显著性差异（Ｐ〈０．０５）。动脉粥样硬化的程度与红细胞膜唾液酸含量呈显著负相关（Ｐ〈０．０１），与血清唾液酸含量呈显著正相关（Ｐ〈０．０５），实验结果提示红细胞膜和血清唾液酸含量的变化与动脉粥样硬化病变的形成及病损程度可能有密切关     

Peritoneal tuberculosis with elevated serum CA125 mimicking peritoneal carcinomatosis on F-18 FDG-PET/CT

18F-fluorodeoxyglucose positron emission tomography (F-18 FDG-PET) plays an important role in differentiating benign from malignant tumors. However, some false-positive findings, such as tuberculosis, may occur. We report a case referred for F-18 FDG whole-body PET computed tomography (PET/CT) scan owing to an elevated serum cancer antigen 125 (CA125). An FDG-PET/CT scan showed multiple hypermetabolic foci in the mesentery and peritoneum with further increase of FDG uptake on the delayed scan, mimicking peritoneal carcinomatosis. Subsequent laparoscopic biopsy showed granulomatous inflammation, and tuberculosis polymerase chain reaction showed a positive result. Serum CA125 returned to normal following treatment with anti-tuberculosis drugs. Peritoneal tuberculosis should be considered as a differential diagnosis in a tuberculosis endemic region.     

雌激素受体显像剂18F-16α-17β-氟雌二醇的自动化合成

目的 使用自动化合成装置Tracerlab FXFN,制备雌激素受体显像剂 18F-16α-17β-氟雌二醇(18F-FES).方法　通过两步反应制备 18F-FES:① 18F-和3-O-(甲氧甲基)-16,17-O-磺酰基-16-表雌二醇发生亲核取代反应;②生成物经HCI水解,重复两次后得到产物 18F-FES.结果 18F-FES的合成总时间约80 min,放化产率约为10%,放化纯度大于95%.结论 整个合成过程自动化完成,操作简便,18F-FES毒性小,对人安全,体外较稳定,有望成为安全、有效的雌激素受体显像剂.

Abstract：

Objective 18F-16α-17β-fluoroestradiol (18F-FES),an estrogen receptors imaging agent,is synthesized with Tracerlab FXFN system.Methods 18F-FES is obtained by two steps reactions,including the nucleophilic displacement reaction of no-carrier-added 18F-fluoride with 3-O-methoxymethyl-16.17-O-sulfuryl-16-epiesteriol,then the intermediate is evaporated and hydrolyzed with HCI and finally gives 18F-FES.Results The synthesis of 18F-FES can be completed in about 80 min.The radiochemical yield and radio-chemical purity are about 10%and 95%respectively.Conclusion The procedure of synthesis is simple and automatical.18F-FES has an extremely low toxicity,which suggests that 18F-FES may be a safe,and effective estrogen receptors imaging agent.     

Clinical implication of F-18 FDG PET/CT for differentiated thyroid cancer in patients with negative diagnostic iodine-123 scan and elevated thyroglobulin

This study aims to investigate the usefulness of F-18 FDG PET/CT in differentiated thyroid cancer (DTC) with elevated serum thyroglobulin (Tg) but negative iodine-123 (I-123) scan.     

High F-18 fluorodeoxyglucose accumulation in solid pseudo-papillary tumors of the pancreas

We report two cases of young women with a solid pseudo-papillary tumor of the pancreas which having cystic and hemorrhagic components with marked calcification on computed tomography and magnetic resonance imaging. F-18 fluorodeoxyglucose positron emission tomography revealed abnormally increased accumulation of F- 18 fluorodeoxyglucose in the pancreas tail tumors, especially in the non-calcified solid portion of the tumors. These patients underwent elective resection of the masses and distal pancreatectomy and were diagnosed with solid pseudo-papillary tumors by histopathological analysis. There was no evidence of distant metastasis on follow-up after surgery and they showed no histopathological findings suggesting malignancy. These cases suggest that solid pseudo-papillary tumor may show high uptake of F-18 fluorodeoxyglucose.     

Uterine Epithelioid Angiosarcoma on F-18 FDG PET/CT

Uterine epithelioid angiosarcoma can have conventional imaging characteristics similar to those of other uterine tumors, such as leiomyoma, leiomyosarcomas or hemangioendothelioma. Uterine epithelioid angiosarcoma exhibiting increased fluorine-18 fluorodeoxyglucose (F-18 FDG) activity can be misdiagnosed. A 61-year-old woman who was diagnosed with uterine epithelioid angiosarcoma underwent F-18 FDG positron emission tomography/computed tomography (PET/CT) as a part of the pretreatment work up for surgery. F-18 FDG PET/CT showed an intense F-18 FDG uptake in the uterus in addition to increased F-18 FDG uptake at the paraaortic and aortocaval lymph nodes. To our knowledge, this is the first case report of intense F-18 FDG uptake in uterine epithelioid angiosarcoma in Korea.     

F-18 fluorodeoxyglucose accumulation in an inflammatory pseudotumor of the spleen

We report on a case with an inflammatory pseudotumor of the spleen, which showed a moderate accumulation of F-18 fluorodeoxyglucose (FDG) in the tumor. F-18 FDG accumulated mainly in the peripheral portion of this tumor that showed abundant hypercellular inflammatory cells histopathologically. Splenic inflammatory pseudotumors should be recognized as F-18 FDG-avid benign tumors of the spleen.     

F-18 FDG PET/CT imaging of low-grade mucoepidermoid carcinoma of the bronchus

Mucoepidermoid carcinomas in the bronchial tree are extremely rare tumors. Such tumors are classified into low-grade and high-grade on the basis of histological criteria. Fluorine-18-fluorodeoxyglucose positron emission tomography (F-18 FDG PET) is a useful technique for the evaluation of pulmonary lesions; however, to our knowledge, F-18 FDG PET findings in mucoepidermoid carcinoma of the bronchus have been described in only a few cases. Identifiable focal F-18 FDG uptake has been reported in high-grade mucoepidermoid carcinoma, but it is unclear whether F-18 FDG accumulates in low-grade mucoepidermoid carcinoma. Here, we present the case of a 37-year-old woman, with pathologically proven low-grade mucoepidermoid carcinoma, who underwent high-resolution computed tomography (CT) and F-18 FDG PET/CT before treatment.     

Improved methods to determine radionuclidic purity of F-18 compounds

Current revisions of monographs for F-18 pharmaceuticals in the European Pharmacopoeia (Ph. Eur.) (Ph. Eur., 2011) call for a radionuclidic purity (RNP) of or better than 99.9%. However, the current method is not sufficient nor effective for testing this required RNP level.We present a theoretical model leading to a practical procedure for a simple test of RNP for F-18 compounds that tells whether or not the sample is pure with a statistical confidence of 97.5% (P=0.975).     

F-18 FDG PET in detecting renal cell carcinoma

Purpose: To assess the role of F-18 FDG imaging with a dual head coincidence mode gamma camera (Co-PET) in the detection of renal cell carcinoma (RCC) in patients with renal masses.

Material and Methods: An F-18 FDG Co-PET study was performed in 19 patients (7 F, 12 M; mean age 58.15±2.5 years, age range 45-79 years) with suspected primary renal tumors based on conventional imaging techniques, including computed tomography (CT) and ultrasonography (US) before nephrectomy or surgical resection of the mass.

Results: Histologically documented RCC was present in 15 patients. Of the 19 patients with suspected primary renal tumors, F-18 FDG Co-PET was true-positive in 13, false-negative in 2, true-negative in 3, and false-positive in 1 patient. Two angiomyolipomas and one renal mass due to infarction and hemorrhage showed a true-negative Co-PET result. The patient with false-positive FDG Co-PET study was diagnosed as xantogranulomatous pyelonephritis. Overall sensitivity, specificity, and accuracy of FDG Co-PET for RCC were 86% (13/15), 75% (3/4), and 84% (16/19), respectively. Positive predictive value for RCC was 92% and negative predictive value 60%.

Conclusion: These findings suggest that F-18 FDG Co-PET may have a role in the diagnostic evaluation of patients with RCC and primary staging of disease. Positive F-18 FDG study may be predictive of the presence of RCC. However, a negative study does not exclude the RCC.     

Monitoring Therapeutic Response in a Case of Extrapulmonary Tuberculosis by Serial F-18 FDG PET/CT

Due to the low yield of AFB smear and culture in extrapulmonary tuberculosis, therapeutic responses of patients with extrapulmonary tuberculosis are usually monitored clinically and/or radiographically. Such monitoring techniques, however, are not enough to provide effective diagnosis if a remnant lesion exists after treatment. Tuberculosis presents hypermetabolic activity on F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) scanning. Reported herein is a case of extrapulmonary tuberculosis where the therapeutic response was assessed via serial F-18 FDG PET/CT scanning, which was useful for detecting the extent of extrapulmonary tuberculosis and for estimating the patient’s therapeutic response.