B超与放射免疫分析诊断卵巢癌的临床价值

为探讨B超与放射免疫分析诊断卵巢癌的临床价值 ,对 45例卵巢癌患者行B超及放射免疫分析血液CEA、CA12 5、TSGF。提示B超与CA12 5、TSGF ,CEA联合检查 ,可提高对卵巢癌的诊断率     

胃癌患者8种肿瘤标志物测定的临床价值

对 30 2例胃癌术前检测CA5 0、CA199、CA12 5、CA72 4、CEA、β2 -MG、SA、Fer等 8种肿瘤标志物 ,并按年龄、胃癌病期及病理分类分组分析。结果 :(1) 30 2例胃癌血清中 8种肿瘤标志物总的阳性率依次为 β2 -MG6 5 .9%、CA19932 .1%、CA72 42 9.5 %、SA2 4.5 %、CA12 5 16 .9%、CEA13 .2 %、CA5 0 11.6 %、Fer(- )。 (2 ) 8种肿瘤标志物阳性率与年龄大小均无关。 (3) β2 -MG、CA72 4、CA12 5、CA199、SA、CEA、在Ⅲ、Ⅳ期病例中均较敏感 ,且随病期增加 ,阳性率增高。 (4 )CA199和CA72 4对腺癌、β2 -MG和SA对低分化腺癌、β2 -MG和CA72 4对粘液癌、混合型癌阳性率较高。提示血清测β2 -MG、CA199、CA72 4、SA、CA12 5对胃癌的辅助诊断有一定应用价值     

子宫腺肌病误诊原因分析及术前诊断临床探讨

目的;探讨子宫腺肌病误诊原因及近年术前诊断研究进展,方法;对我院近１０年收治的１９７例腺肌病患者的临床资料进行回顾性分析。结果：１９９０年元月至１９９７年１２月１２８例腺肌病患者术前,术后诊断符合率仅为２９．７％,术后误诊,漏诊率达７０．３％,１９９８年元月至１９９９年１２月６９例术前经测定血清ＣＡ１２５及 腔双氧水造影后误诊,漏诊率降为２７．５％术前主要误诊为子宫肌瘤或（和）子宫内膜异位症,结论     

Axsym仪检测血清CA125对卵巢肿瘤的诊断及鉴别诊断的意义

目的：探讨Ａｘｓｙｍ仪检测血清ＣＡ１２５对妇科卵巢肿瘤的诊断及鉴别诊断的意义。方法：采用微粒子酶免分析法（ＭＥＩＡ）检测妇科疾病患者血清ＣＡ１２５,并将结果与病理结果对照分析。结果：卵巢上皮癌血清ＣＡ１２５值明显高于卵巢良性肿瘤血清ＣＡ１２５,两者之间有显著的统计学意义（Ｐ〈０．０１）,卵巢上皮癌血清ＣＡ１２５阳性率为１００％。结论：应用Ａｘｓｙｍ义检测血清ＣＡ１２５对卵巢肿瘤的诊断及鉴别诊断具有     

子宫内膜异位症癌抗原(CA125)检测及其临床意义

目的：探讨子宫内膜异位症与ＣＡ１２５有无相关性、提高临床子宫内膜异位症诊断雍诊断最佳途径。方法：用放射免疫测定法（ＲＩＡ）检测７９例子宫内膜异位症、７０例子宫肌瘤、６４例子宫颈癌、８０名正常育龄女性为对照。结果：子宫内膜异位症、子宫肌瘤、子宫颈癌、正常对照组阳性率分别是７９．７５％、８．５７％、１７．１９％、０．００％。前者显著高于后三者（Ｐ〈０．０１）。结论：ＣＡ１２５检测为临床诊断子宫内膜异位     

CA125与TSGF联合检测在卵巢癌中的临床应用

为探讨ＣＡ１２５ 、ＴＳＧＦ 联合测定在卵巢癌诊断、疗效观察中的价值,分别测定正常妇女、卵巢良性肿瘤患者和７５ 例卵巢癌患者术前和术后或治疗后的血清ＣＡ１２５ 、ＴＳＧＦ 水平。结果：卵巢癌患者ＣＡ１２５ 、ＴＳＣＦ 阳性率分别为８８ ．０ ％ 、９０ ．７ ％ ,联合测定阳性率为９６ ．０ ％ ;随访５１ 例术后患者中,有１６ 例患者血清ＣＡ１２５ 和（ 或） ＴＳＧＦ 升高,在血清学变化的３～１２ 个月内被临床证实转移或复发。认为联合测定ＣＡ１２５ 、ＴＳＧＦ 不仅可提高卵巢癌的阳性诊断率,还可进行疗效观察及术后监测,且能达到早期诊断的目的。     

Iodine-123-labelled fatty acids for myocardial single-photon emission tomography: current status and future perspectives

Renewed interest in the clinical use of iodine-123-labelled fatty acids is currently primarily focused on the use of iodine-123-labelled 15-(p-iodophenyl)pentadecanoic acid (IPPA) and modified fatty acid analogues such as 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) which show delayed myocardial clearance, thus permitting single-photon emission tomographic imaging. Interest in the use of BMIPP and similar agents results from the differences which have often been observed in various types of heart disease between regional myocardial uptake patterns of [¹²³I]BMIPP and flow tracer distribution. Although the physiological basis is not completely understood, differences between regional fatty acid and flow tracer distribution may reflect alterations in important parameters of metabolism which can be useful for patient management or therapy planning. These tracers may also represent unique metabolic probes for correlation of energy substrate metabolism with regional myocardial viability. The two agents currently most widely used clinically are¹²³I-labelled IPPA and BMIPP. While [¹²³I]IPPA is commercially available as a radiopharmaceutical in Europe (Cygne) and Canada (Nordion), multicenter trials are in progress in the United States as a prelude to approval for broad use. [¹²³I]BMIPP was recently introduced as Cardiodine for commercial distribution in Japan (Nihon Medi-Physics, Inc.). [¹²³I]BMIPP is also being used in clinical studies on an institutional approval basis at several institutions in Europe and the United States. In this review, the development of a variety of radioiodinated fatty acids is discussed. The results of clinical trials with [¹²³I]IPPA and [¹²³I]BMIPP are discussed in detail, as are the future prospects for fatty acid imaging.     

Fluorine-18 fluorodeoxyglucose positron emission tomography in the follow-up of differentiated thyroid cancer

Whole-body fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging was performed during the follow-up of 33 patients suffering from differentiated thyroid cancer. Among them there were 26 patients with papillary and seven with follicular tumours. Primary tumour stage (pT) was pT1 in six cases, pT2 in eight cases, pT3 in three cases and pT4 in 14 cases. FDG PET was normal in 18 patients. In three patients a slightly increased metabolism was observed in the thyroid bed, assumed to be related to remnant tissue. In one case local recurrence, in ten cases lymph node metastases (one false-positive, caused by sarcoidosis) and in three cases distant metastases were found with FDG PET. In comparison with whole-body scintigraphy using iodine-131 (WBS) there were a lot of discrepancies in imaging results. Whereas three patients had distant metastases (proven with¹³¹I) and a negative FDG PET, in four cases¹³¹I-negative lymph node metastases were detectable with PET. Even in the patients with concordant staging, differences between¹³¹I and FDG were observed as to the exact lesion localization. Therefore, a coexistence of¹³¹I-positive/FDG-negative,¹³¹I-negative/FDG-positive and¹³¹I-positive/FDG-positive malignant tissue can be assumed in these patients. A higher correlation of FDG PET was observed with hexakis (2-methoxyisobutylisonitrile) technetium-99m (I) (MIBI) scintigraphy (performed in 20 cases) than with WBS. In highly differentiated tumours¹³¹I scintigraphy had a high sensitivity, whereas in poorly differentiated carcinomas FDG PET was superior. The clinical use of FDG PET can be recommended in all cases of suspected or proven recurrence and/or metastases of differentiated thyroid cancer and is particularly useful in cases with elevated serum thyroglobulin levels and negative WBS.     

Delayed image of iodine-123 iomazenil as a relative map of benzodiazepine receptor binding: The optimal scan time

Delayed single-photon emission tomograpic (SPET) images after an intravenous bolus injection of iodine-123 iomazenil have been used as a relative map of benzodiazepine receptor binding. We determined the optimal scan time for obtaining such a map and assessed the errors of the map. SPET and blood data from six healthy volunteers and five patients were used. A three-compartment kinetic model was employed in simulation studies and analyses of actual data. The simulation studies suggested that, in the normal brain, the scan time at which a single SPET image best represented the relative receptor binding was 3.0–3.5 h post-injection. This finding was supported by actual data from the volunteers. The simulation studies also suggested that the optimal scan time was not greatly changed by the variability of the input functions, and that the error in the SPET image contrast in the vicinity of the optimal scan time was not increased by changes in the tracer kinetics in the entire brain. The SPET image contrast in the patients at 3.0 h post-injection agreed well with the reference receptor binding estimated by kinetic analysis, with a mean error of 3.6%. These findings support the use of a single SPET image after bolus injection of [¹²³I]iomazenil as a relative map of benzodiazepine receptor binding. For this purpose, a SPET scan time of 3.0-3.5 h post-injection is recommended.     

Uptake of iodine-123-α-methyl tyrosine by gliomas and non-neoplastic brain lesions

Using single-photon emission tomography (SPET), the radiopharmaceuticall,-3-iodine-123--methyl tyrosine (IMT) has been applied to the imaging of amino acid transport into brain tumours. It was the aim of this study to investigate whether IMT SPET is capable of differentiating between high-grade gliomas, low-grade gliomas and non-neoplastic brain lesions. To this end, IMT uptake was determined in 53 patients using the triple-headed SPET camera MULTISPECT 3. Twenty-eight of these subjects suffered from high-grade gliomas (WHO grade III or IV), 12 from low-grade gliomas (WHO grade II), and 13 from non-neoplastic brain lesions, including lesions after effective therapy of a glioma (five cases), infarctions (four cases), inflammatory lesions (three cases) and traumatic haematoma (one case). IMT uptake was significantly higher in high-grade gliomas than in low-grade gliomas and non-neoplastic lesions. IMT uptake by low-grade gliomas was not significantly different from that by non-neoplastic lesions. Diagnostic sensitivity and specificity were 71% and 83% for differentiating high-grade from low-grade gliomas, 82% and 100% for distinguishing high-grade gliomas from non-neoplastic lesions, and 50% and 100% for discriminating low-grade gliomas from non-neoplastic lesions. Analogously to positron emission tomography with radioactively labelled amino acids and fluorine-18 deoxyglucose, IMT SPET may aid in differentiating high-grade gliomas from histologically benign brain tumours and non-neoplastic brain lesions; it is of only limited value in differentiating between non-neoplastic lesions and histologically benign brain tumours.