^18F-FDG-PET/CT早期预测鼻咽癌放疗疗效的应用价值

目的18F-FDG-PET能否早期监测放疗疗效目前仍有争议,放射治疗后何时行18F-FDG-PET检查既能评价放疗响应又能排除放疗引起放射性炎症对检查结果的影响,仍没有统一标准。本研究旨在研究^18F-FDG-PET对评价鼻咽鳞癌早期放疗响应的临床价值。方法自2009年3月至2009年11月,我院入组的32例确诊的初治鼻咽鳞癌患者,所有患者在治疗前一周和放疗中（DT50Gy/25F,5W）及放疗结束（DT70Gy/25F,7W）后1周内分别行18F-FDG-PET/CT检查,分别计算相关指标。结果32例患者中与放疗前相比,放疗中及放疗结束一周内SUVmax均明显下降,治疗前（单纯放疗或放化疗同步治疗）原发病灶SUVmax值平均值为（12.1±5.51）（2.70～24.5）,放中SUVmax值平均值为（3.69±1.97）（1.3～7.60）,放疗结束一周内SUVmax值平均值为（3.06±1.63）（1.20～7.50）。三组数据均提示放疗过程中^18F-FDG最大标准摄取值（SUVmax）逐步降低（P〈0.001）。结论^18F-FDG-PET可能能够早期监测鼻咽癌放疗响应,有利于决定下一步治疗方案,作为设计放疗总剂量或综合应用手术、化疗提供一些依据。     

99mTc-HL91乏氧显像探测肿瘤乏氧状态的研究进展

乏氧显像剂99mTc-HL91能选择性地浓集于肿瘤的乏氧组织或细胞中,通过核医学显像探测肿瘤组织的乏氧,能直接提供肿瘤组织乏氧及其乏氧程度和分布的证据,不仅能用于恶性肿瘤的早期诊断,还能动态监测肿瘤组织乏氧状态,为临床诊断和治疗决策提供重要信息。     

~(99m)Tc-tetrofosmin显像诊断恶性黑色素瘤

介绍两例均被确诊为皮肤恶性黑色素瘤(MM)的诊断报告。1例男性,31岁,为原发性病灶,皮肤组织分型为型,右乳晕先天性黑色素痣增大3cm已有10年,未触及局部肿大淋巴结。另1例女性,50岁,已有转移病灶,右足跟部原发性MM(按AJCC分型为Ib),经原发性灶+局部淋巴结切除术后发现皮肤有多发性直径在0.6～1.7cm的转移灶(前胸壁、背部、双臂、双大腿、右臀部);左乳房和颅内也发现转移病灶,经乳房穿刺活检和头颅X-CT证实;腋下未触及肿大淋巴结。两个患者均在足背静脉注射370MBq99m　Tc-tetrofosmin后15分钟,以16cm/min的速度用低能高分辨准直器采集全…     

99Tc-HL91乏氧显像评价30例鼻咽癌患者放疗疗效

目的 探讨99mTc-4,9-二氮杂-3,3,10,10-四甲基十二烷-2,11-二酮二肟(99Tc-HL91)乏氧显像评价鼻咽癌放疗疗效的临床价值.方法 鼻咽癌患者30例,放疗前经肘静脉注射99mTc-HL91 1110 MBq后1h、4h,分别进行头颈部SPECT,用感兴趣区技术求出肿瘤组织/头皮本底(T/B)比值,放疗结束后4周按WHO标准进行放疗疗效评价.结果 ①30例鼻咽癌患者99mTc-HL91显像1h和4h的T/B比值均值分别为1.370±0.207和1.883±0.358,具有统计学差异(t=6.794,P＜0.001).②放疗有效组与无效组的1h和4h T/B比值均值分别为1.273±0.196与1.498±0.147和1.679±0.232与2.152±0.318,也具有统计学差异.结论 99mTc-HL91显像可探测鼻咽癌病灶乏氧状态,在预测放疗疗效方面有一定的应用价值.     

各型甲状腺肿瘤组织中生长抑素受体的表达

目的 用原位杂交方法 观察生长抑素受体在甲状腺肿瘤组织及癌旁组织中的表达.方法 根据生长抑素受体(SSTR)亚型的基因结构设计两种cDNA探针:针对各型生长抑素受体的寡核苷酸探针以及特异性针对二型生长抑素受体(SSTR2)的寡核苷酸探针序列,并分别与各型甲状腺肿瘤组织及癌旁组织行原位杂交,采用Mias图像分析仪进行灰度分析, mRNA丰度以信号强度x-±s表示,进行t检验.结果 甲状腺髓样癌组织中SSTR的表达明显高于癌周组织(P＜0.05),SSTR2仅在癌组织中有表达.SSTR在甲状腺乳突状癌组织中的表达明显高于癌周组织(P＜0.05),SSTR2在癌组织及癌周组织内均未见有表达.滤泡性腺癌组织SSTR的表达明显高于癌周组织(P＜0.05),癌组织及癌周组织均未见有SSTR2表达.嗜酸性细胞癌组织SSTR的表达明显高于癌周组织(P＜0.05),SSTR2仅在癌组织中有表达.结论 SSTR2仅在MTC及HCC的肿瘤组织中有表达;各型甲状腺肿瘤组织均表达除SSTR2之外的其他几型SSTR中的一种或数种,且肿瘤组织中的表达强度明显高于邻近正常组织.某些靶向生长抑素受体(尤其是特异性靶向SSTR2)的化合物(配体),可能成为甲状腺肿瘤尤其是甲状腺髓样癌和嗜酸性细胞癌的特异性显像剂和靶向治疗载体.     

99Tcm-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

Objective 99Tcm-4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime (HL91) is a new hypoxia imaging agent that demonstrates increased uptake and retention in tumor hypoxic tissues in vivo. The objective of this study was to evaluate the clinical value of 99Tcm-HL91 hypoxia imaging in post-therapeutic patients with cancers. Methods Thirty-seven patients with primary cancers at head and neck and upper aerodigestive region who were suspected to have residual, recurrent, or metastatic disease at either clinical follow-up or by regular CT follow-up, were included. All underwent 99Tcm-HL91 imaging. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest (ROI) technique. A t-test was used for data analysis. The " gold standard" of diagnostic accuracy was based on histopathology or clinical follow-up. Results were compared between 99Tcm-HL91 and CT. Results Of the 37 patients, 11 had either residual or recurrent lesions and 7 had distant disease. (1) A significantly higher 99Tcm-HL91 uptake were noted in residual or recurrent lesions than benign lesions (1.58 ± 0. 16 vs 1.18 ±0.14, t =4. 87, P <0.001). (2) The sensitivity, specificity, and accuracy for residual or recur-rent lesions were 72. 73% (8/11), 63.64% (7/11), 4/4; 89.47% (17/19), 84. 21% (16/19), 94. 12% (16/17), and 83.33% (25/30), 76.67% (23/30), 95.24% (20/21) in 99Tcm-HL91, CT, and combined 99Tcm-HL91 and CT, respectively. (3) For distant sites detection (n = 7), CT detected all but 99Tcm-HL91 missed three. Conclusions A combination of 99Tcm-HL91 and CT in detection either residu-al, recurrent, or metastatic disease would have the highest benefit in patients with cancers at head and neck and upper aerodigestive region.     

甲亢患者的体液免疫研究

为全面评价甲亢（Ｇｒａｖｅｓ病）患者的体液免疫状态，以１０８例患者和２１５例健康者分别为试验组和对照组，按血清总、游离和复合ＩｇＭ、ＩｇＧ、ＩｇＡ、Ｃ３及非特异性免疫复合物等１４个指标进行比较研究。结果发现，患者的总和游离ＩｇＭ、Ｃ３显著升高，而复合Ｉｇ和Ｃ３均显著下降，且与有关特异性临床实验室指标有关；在总和游离Ｉｇ池无明显改变和复合Ｉｇ池显著下降的基础上，各Ｉｇ比例均发生变化。这些结果提示，Ｇｒａｖｅｓ病存在整体的体液免疫紊乱。同时说明，复合Ｉｇ检测和Ｉｇ池比例研究的重要性。     

99Tcm-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

Objective 99Tcm-4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime (HL91) is a new hypoxia imaging agent that demonstrates increased uptake and retention in tumor hypoxic tissues in vivo. The objective of this study was to evaluate the clinical value of 99Tcm-HL91 hypoxia imaging in post-therapeutic patients with cancers. Methods Thirty-seven patients with primary cancers at head and neck and upper aerodigestive region who were suspected to have residual, recurrent, or metastatic disease at either clinical follow-up or by regular CT follow-up, were included. All underwent 99Tcm-HL91 imaging. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest (ROI) technique. A t-test was used for data analysis. The " gold standard" of diagnostic accuracy was based on histopathology or clinical follow-up. Results were compared between 99Tcm-HL91 and CT. Results Of the 37 patients, 11 had either residual or recurrent lesions and 7 had distant disease. (1) A significantly higher 99Tcm-HL91 uptake were noted in residual or recurrent lesions than benign lesions (1.58 ± 0. 16 vs 1.18 ±0.14, t =4. 87, P <0.001). (2) The sensitivity, specificity, and accuracy for residual or recur-rent lesions were 72. 73% (8/11), 63.64% (7/11), 4/4; 89.47% (17/19), 84. 21% (16/19), 94. 12% (16/17), and 83.33% (25/30), 76.67% (23/30), 95.24% (20/21) in 99Tcm-HL91, CT, and combined 99Tcm-HL91 and CT, respectively. (3) For distant sites detection (n = 7), CT detected all but 99Tcm-HL91 missed three. Conclusions A combination of 99Tcm-HL91 and CT in detection either residu-al, recurrent, or metastatic disease would have the highest benefit in patients with cancers at head and neck and upper aerodigestive region.     

99Tcm-HL91乏氧显像在恶性肿瘤治疗后随访中的应用

Objective 99Tcm-4, 9-diaza-3, 3, 10, 10-tetramethyldodecan-2, 11-dione dioxime (HL91) is a new hypoxia imaging agent that demonstrates increased uptake and retention in tumor hypoxic tissues in vivo. The objective of this study was to evaluate the clinical value of 99Tcm-HL91 hypoxia imaging in post-therapeutic patients with cancers. Methods Thirty-seven patients with primary cancers at head and neck and upper aerodigestive region who were suspected to have residual, recurrent, or metastatic disease at either clinical follow-up or by regular CT follow-up, were included. All underwent 99Tcm-HL91 imaging. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest (ROI) technique. A t-test was used for data analysis. The " gold standard" of diagnostic accuracy was based on histopathology or clinical follow-up. Results were compared between 99Tcm-HL91 and CT. Results Of the 37 patients, 11 had either residual or recurrent lesions and 7 had distant disease. (1) A significantly higher 99Tcm-HL91 uptake were noted in residual or recurrent lesions than benign lesions (1.58 ± 0. 16 vs 1.18 ±0.14, t =4. 87, P <0.001). (2) The sensitivity, specificity, and accuracy for residual or recur-rent lesions were 72. 73% (8/11), 63.64% (7/11), 4/4; 89.47% (17/19), 84. 21% (16/19), 94. 12% (16/17), and 83.33% (25/30), 76.67% (23/30), 95.24% (20/21) in 99Tcm-HL91, CT, and combined 99Tcm-HL91 and CT, respectively. (3) For distant sites detection (n = 7), CT detected all but 99Tcm-HL91 missed three. Conclusions A combination of 99Tcm-HL91 and CT in detection either residu-al, recurrent, or metastatic disease would have the highest benefit in patients with cancers at head and neck and upper aerodigestive region.     

下调TSPO表达不影响脂多糖诱导的小胶质细胞TNF-α和IL-1β以及IL-6的分泌

目的研究相对分子质量(Mr)18 000转运蛋白(TSPO)基因表达下调对脂多糖(LPS)诱导BV-2小胶质细胞分泌TNF-α,IL-1β和IL-6的影响。方法以RNA干扰技术建立TSPO基因表达下调的细胞模型,实时荧光定量PCR(qRT-PCR)和Western blot法检测转染TSPO siRNA BV-2细胞TSPO mRNA及蛋白水平表达的效果;用qRT-PCR法检测TSPO基因下调后小胶质细胞BV-2在LPS作用下分泌TNF-α、IL-1β和IL-6的mRNA水平表达的情况;ELISA检测TSPO基因下调小胶质细胞BV-2在LPS作用下分泌TNF-α、IL-1β和IL-6的蛋白水平表达的变化。结果成功建立了TSPO基因下调的细胞模型,稳定表达TSPO siRNA细胞的TSPO mRNA和蛋白水平表达均明显下降,TSPO基因下调后BV-2细胞在LPS作用下分泌TNF-α、IL-1β和IL-6的量无变化。结论下调TSPO的表达对LPS刺激引起的小胶质细胞TNF-α、IL-1β和IL-6的分泌无明显影响。