18F-FDG PET-CT对裸鼠鼻咽癌移植瘤放疗疗效的早期评估及与Ki67表达的相关性研究

Objective To investigate the value of 18F-FDG PET-CT scans on early assessing the therapeutic effects on human nasopharyngeal carcinoma (NPC) xenograft in nude mice after radiotherapy,and preliminarily analyze the relation of 18F-FDG PET-CT scans and the positive expression rate of Ki67, and provide a basis for further clinical studies. Methods Fifteen xenograft nude mice of NPC were randomly divided into three groups (5 nude mice per group). Control group: all mice immediately executed after the 18F-FDG PET-CT scans and taken pathology; 6 Gy radiotherapy group: all mice took 18F-FDG PET-CT scans before and 1 d after receiving 6 Gy irradiation, and were killed immediately to take pathology; 12 Gy radiotherapy group: all mice received 12 Gy irradiation (6 Gy each time, totally 2 times). They took 18F-FDG PET-CT scans before radiotherapy, after receiving the first 6 Gy irradiation, 2 d and 6 d after receiving 12 Gy irradiation respectively ,and then were executed to take pathology after the last scan. The expression of Ki67 in xenografts of different groups was detected and the relation between their changes and T/NT were analyzed.Results ①For 12 Gy radiotherapy group, the average T/NT ratios of the NPC xenograft of pre-radiotherapy, after the first 6 Gy irradiation, 2 d and 6 d after 12 Gy radiotherapy were 2.17±0.31, 1.68±0.42, 1.41±0.40,and 0.70±0.12, respectively. The average T/NT ratios were not statistically difference before and after the first 6 Gy irradiation. The average T/NT ratio of 2 d after radiotherapy decreased significantly than pre-radiotherapy (t=2.80, P<0.05) and after the first 6 Gy irradiation (t=3.14, P<0.05); The average T/NT ratio of 6d after radiotherapy was decreased seriously than 2 d after radiotherapy(t=3.49, P<0.05, compared with preradiotherapy t=8.01, P<0.01). ② The positive expression rates of Ki67 of NPC xenograft markedly decreased after receiving irradiation. There were significant differences in the positive expressions of Ki67 between different group s(F=21.95, P<0.01).The positive expression of Ki67 in the 12 Gy radiotherapy group decreased significantly compared with the control group (t=7.145, P<0.01) and the 6 Gy radiotherapy group (t=2.384, P<0.05). The positive expression of Ki67 in the 6 Gy radiotherapy group was less than the control group, also have statistical significance(t=4.320, P<0.01).③There was no correlation between the T/NT ratio of NPC xenograft and the positive expression of Ki67. ④Positive correlation was found between the variance of T/NT ratio and the variance of the positive expression of Ki67 of NPC xenograft (r=0.532, P<0.05).Conclusions 18F-FDG PET-CT imaging has an important value on early assessing the therapeutic effects of NPC xenograft in nude mice after radiotherapy, and the 6th day after radiotherapy is an appropriate time point.18F-FDG PET-CT imaging can reflect the variance of the positive expression of Ki67 of NPC, and yet indirectly reflect the sensitivity of NPC to radiotheraphy.     

18F-FDG心肌代谢显像前m糖浓度调节的护理

[目的]探讨18F-氟代脱氧葡萄糖(18F-FDG)心肌代谢显像前调节血糖水平与图像质量关系,并总结护理体会.[方法]1 8例冠心病病人常规18F-FDG心肌代谢显像.其中14例无糖尿病史的病人采用葡萄糖负荷法,即病人在注射18F-FDG前1 h禁食状态下口服葡萄糖5 g～75 g;4例合并糖尿病的病人应用普通胰岛素5 U～8 U皮下注射或用8 U～12 U胰岛素加入生理盐水200m1静脉输注;血糖浓度采用Glucotrend血糖测定仪测定.[结果]当血糖水平高于8.8 mmol/L或低于7.9mmol/L时,心肌摄取18F-FDG减少,心肌显像欠清晰;当血糖水平在7.9 mmol/L～8.8 mmol/L时,心肌显像清晰度满意.[结论]合理控制血糖水平是保障18F-FDG心肌代谢显像质量,实现影像分析并最终作出正确诊断的基础.正确指导病人检查前的饮食与用药,严密监测并合理控制血糖水平,加强心理护理也是保证影像质量的关键.     

血友病滑膜炎患者放射性核素~(32)P胶体滑膜切除术围手术期的护理

<正>我科2006年7月至2009年1月对35例血友病患者的42个关节实施了32P胶体滑膜切除术,取得了良好效果,现报告如下。1资料与方法1.1临床资料:35例均为男性患者。其中甲型血友病32例,乙型血友病3例,年龄7～27岁,平均16.8岁。共治疗42个关     

99mTc-HL91肺部恶性肿瘤乏氧显像的临床研究

目的 :评估 99mTc-HL91体外显像对肺部恶性肿瘤乏氧组织探测能力。方法 :33例肺部原发性恶性肿瘤 (2 1例肺腺癌和 12例肺鳞癌 )和 8例肺部转移性肿瘤患者在给药 99mTc-HL91(92 5MBq)后 180min完成前位和后位静态显像。计算病灶和对侧正常肺组织摄取 99mTc -HL91的放射性计数比 (T/N)。结果 :99mTc-HL91在肺部原发性肺癌中的阳性率为 33/ 33(10 0 % ) ,T/N值为 1.5 4± 0 .18(其中腺癌组为 1.5 1±0 .2 0 ,鳞癌组为 1.6 0± 0 .12 ,P >0 .0 5 ) ;在肺转移性肿瘤中的阳性率为 7/ 8,T/N值为 1.4 2± 0 .2 7(与原发性肺癌组比较P >0 .0 5 )。结论 :99mTc -HL91在给药 3h后能很好地显示肿瘤的乏氧组织 ,具有良好的灵敏度。     

11例核素肺通气/肺灌注显像诊断肺栓塞的观察和护理

目的 :为了提高肺通气 /肺灌注 (V/ Q)显像对肺栓塞诊断的准确性 ,探讨影响 (V/ Q)显像质量的因素 ,给予护理干预。方法 :通过对 11例可疑肺动脉栓塞 (PE)病人行 (V/ Q)显像 ,对其中 1例同时进行 99m Tc-大颗粒聚合白蛋白 (MAA)下肢静脉和肺灌注显像进行的观察 ,有针对性地实施护理措施。结果 :11例可疑 PE病人中 ,有 9例 (V/ Q)显像图像质量清晰 ,有 2例 (V/ Q)显像中的肺通气不成功。结论 :肺通气显像的成败取决于患者吸气的方法 ,应从加强病人在检查前作有效的腹式呼吸训练着手 ,有针对性地实施护理措施 ,是提高 (V/ Q)显像成功与否的关键     

90Sr- 90Y小剂量敷贴与噻吗洛尔局部外用及其联合应用治疗浅表型婴幼儿血管瘤的前瞻性队列研究

目的:探讨 90Sr- 90Y β射线小剂量敷贴治疗与噻吗洛尔局部外用及其联合应用治疗浅表型婴幼儿血管瘤的疗效及安全性。 方法:前瞻性纳入2013年5月14日至2017年4月11日广东省佛山市第一人民医院核医学科的400例浅表型血管瘤患儿[男126例,女274例,5.3(3.9,7.1...     

鼻咽癌Ki67表达与放疗前后18F-FDG PET-CT显像相关性的动物模型及临床研究

 目的探讨鼻咽癌Ki67表达与放疗前后SUVmax变化的关系。 方法（1）17只裸鼠鼻咽癌移植瘤模型随机分成对照组、6 Gy放疗组及12 Gy放疗组,各组在放疗前后进行18F-FDG PET-CT显像,并于放疗结束后检测瘤体中Ki67表达的情况,对移植瘤的T/NT与Ki67表达水平变化进行分析;（2）12例初治鼻咽癌患者于放疗前、放疗50 Gy时及放疗结束后1周分别行18F-FDG PET-CT显像,测定SUVmax;另外取其放疗前活检蜡块,用免疫组织化学方法检测组织中Ki67蛋白表达情况,分析Ki67表达与放疗前后SUVmax变化的关系。 结果(1) 鼻咽癌移植瘤Ki67抗原的表达随放疗剂量的增加明显降低,不同组别间Ki67的表达差异有统计学意义（F=57.8,P＜0.01）;（2）不同组别间T/NT差异有统计学意义（F=14.0,P＜0.01）。(3)初治鼻咽癌患者在放疗50Gy时,Ki67 高表达的患者SUVmax水平明显低于低表达者,两者差异有统计学意义（t=2.235,P＜0.05）,而在放疗前(t=0.176,P>0.05)及放疗结束后则差异没有统计学意义（t=1.106,P>0.05）。 结论Ki67是影响鼻咽癌细胞FDG摄取的重要因素,放疗前Ki67的表达水平可能对放疗过程中鼻咽癌SUVmax的下降有重要影响。     

131I治疗分化型甲状腺癌引起唾液腺急性损伤的护理

[目的]探讨有效预防131I治疗分化型甲状腺癌引起唾液腺急性损伤的护理干预措施.[方法]将入组病人43例随机分为观察组（22例）和对照组（21例）,观察组采取综合护理干预措施,对照组采取常规护理.两组病人分别于治疗前1d和治疗后第7天进行口干问卷调查和唾液腺功能测定.[结果]观察组发生急性唾液腺损伤2例（9.1%）,对照组发生9例（42.9%）,两组腮腺排泄率比较差异具有统计学意义（P〈0.05）,两组颌下腺排泄率比较差异无统计学意义（P〉0.05）.[结论]采取综合护理干预措施能有效减少唾液腺的急性损伤.     

~(131)I治疗分化型甲状腺癌引起唾液腺急性损伤的护理

[目的]探讨有效预防131I治疗分化型甲状腺癌引起唾液腺急性损伤的护理干预措施。[方法]将入组病人43例随机分为观察组(22例)和对照组(21例),观察组采取综合护理干预措施,对照组采取常规护理。两组病人分别于治疗前1d和治疗后第7天进行口干问卷调查和唾液腺功能测定。[结果]观察组发生急性唾液腺损伤2例(9.1%),对照组发生9例(42.9%),两组腮腺排泄率比较差异具有统计学意义(P0.05),两组颌下腺排泄率比较差异无统计学意义(P0.05)。[结论]采取综合护理干预措施能有效减少唾液腺的急性损伤。     

18F—FDG心肌代谢显像前血糖浓度调节的护理

[目的]探讨18F-氟代脱氧葡萄糖(18F-FDG)心肌代谢显像前调节血糖水平与图像质量关系，并总结护理体会。[方法]18例冠心病病人常规18F—FDG心肌代谢显像。其中14例无糖尿病史的病人采用葡萄糖负荷法，即病人在注射18F—FDG；前1h禁食状态下口服葡萄糖5g～75g；4例合并糖尿病的病人应用普通胰岛素5U～8U皮下注射或用8U～12U胰岛素加入生理盐水200ml静脉输注：血糖浓度采用Glucotrend血糖测定仪测定。[结果]当血糖水平高于8．8mmol／L或低于7．9mmol/L时，心肌摄取18F—FDG减少，心肌显像欠清晰；当血糖水平在7．9mmol／L～8．8mmol／L时，心肌显像清晰度满意。[结论]合理控制血糖水平是保障18F—FDG心肌代谢显像质量，实现影像分析并最终作出正确诊断的基础。正确指导病人检查前的饮食与用药，严密监测并合理控制血糖水平，加强心理护理也是保证影像质量的的关键。