99Tcm-HL91肺癌显像评估非小细胞肺癌放射治疗敏感性的临床价值

目的探讨99Tcm-HL91肺癌显像评估非小细胞肺癌放射治疗敏感性的临床价值.方法对33例拟进行放射治疗的非小细胞肺癌患者静脉注射99Tcm-HL91后4h(早期相)、24h(延迟相)进行断层显像,在断层图像上勾画肿瘤区及对侧正常肺组织的感兴趣区,计算半定量指标早期相摄取比值(ER)及延迟相摄取比值(DR).根据放疗前后的CT影像将患者分为敏感组和不敏感组,将半定量指标与放疗前后的CT检查结果对照.结果肺鳞癌患者敏感组与不敏感组ER及DR值均有显著性差异(P<0.01),不敏感组ER及DR值明显高于敏感组,肺腺癌患者敏感组与不敏感组ER及DR值均无显著性差异(P>0.05),鳞癌患者ER及DR值明显高于腺癌(P<0.01).结论 99Tcm-HL91肺癌显像评估肺鳞癌患者放射治疗敏感性有较大价值,高ER及DR患者对放射治疗不敏感,而对腺癌患者价值有限.

The value of 99Tcm-HL91 lung carcinoma imaging for the evaluation of radiotherapeutic response in non-small cell lung cancer patients

Objective To investigate the value of 99Tc m-HL91 lung carcinoma imaging for the evaluation of radiotherapeutic response in non-small cell lung cancer patients.Methods Thirty-three patients with non-small cell lung cancer who will receive radiotherapy underwent lung tomography imaging at 4h(early imaging),24h(delayed imaging) after injection of 99Tc m-HL91.Region of interests(ROIS) were drawn in the tumor and contralateral position in the tomography to caculate the semiquantitative measurements of the early T/N ratio(ER) and delayed T/N ratio(DR).The patients were divided into responder group and non-responder group according to the CT imaging before radiotherapy and after radiotherapy.The semiquantitative measurements results were compared with the CT imaging.Results The ER,DR of lung squamous cell cancer in non-responder group were significantly higher than those in responder group(P<0.01).While between non-responder group and responder group,there were no significant differences of ER and DR in lung adenocarcinoma(P>0.05).The ER,DR in squamous cell cancer were significantly higher than those in adenocarcinoma(P<0.01).Conclusion 99Tc m-HL91 lung tomography imaging is very useful for evaluating the radiotherapeutic response in squamous cell cancer and higher ER and DR patients have poor response,while in adenocarcinoma,it has limited value.