Ga67显像评估纵隔大B细胞淋巴瘤治疗预后的研究

目的:本研究旨在评价纵隔大B细胞淋巴瘤Ga67显像预测疗效的临床价值。方法:39例病人中女24例,男15例,平均年龄(48±5.6)岁,临床病史及组织病理学诊断为纵隔大B细胞淋巴瘤。分别在化疗前、化疗结束后1个月和放疗结束后3个月进行常规的Ga67 SPECT和CT显像,图像分析采用常规的定性方法。结果:Ga67显像结果:在39例病人治疗结束后,有32例病人肿瘤Ga67显像结果为阴性,提示治疗完全有效,随访证实阴性预测率为94%(30/32);7例病人治疗后Ga67显像阳性,表示治疗部分有效或治疗无效。随访证实阳性预测率为86%(6/7),提示Ga67显像阴性的病人预后很好,而治疗后Ga67显像阳性预后很差。CT扫描结果:39例病人进行了治疗前后的胸、腹和盆腔CT扫描,其阴性预测率为83%;而阳性预测率只有25%。结果提示与Ga67显像相比,CT预测疗效的结果难于区分治疗有效、部分有效或无效。结论:Ga67显像在评价纵隔大B细胞淋巴瘤病人治疗反应中明显优于CT扫描。

Gallium-67 scintigraphy evaluation of therapeutic prognosis in the mediastinal large B-cell lymphoma

Objective: To evaluate the clinical value of Gallium-67(Ga67) scan in the patients with mediastinal large B-cell lymphoma. Methods: In 39 patients proven histopathologically and clinically with the mediastinal large B-cell lym phoma, Ga67 SPECT and CT scans were performed before chemotherapy, after one mon th of chemotherapy and three months of radiotherapy respectively. Results: After therapy, Ga67 imaging showed that 32 of the 39 patients had normal uptake of Ga 67, suggesting complete response (CR) to the therapy in these patients, follow-u p showed the negative predictive rate(NPR) is 94%(30/32). Positive Ga67 uptake i maging after therapy in 7 cases showed that the treatment was of partial respons e(PR) or no response. Follow up result showed that the positive predictive value was 86%(6/7). That means positive Ga67 uptake indicated the prognosis will be g ood, while positive Ga67 uptake indicated the prognosis will be poor. Results of CT scanning: thoracic, abdominal, pelvic CT examination was performed in 39 pat ients before and after therapy, the NPR was 83%, and positive predictive value w as 25%. Compare to Ga67 uptake imaging, CT has difficulty in evaluating the ther apeutic effect. Conclusion: The findings showed that Ga67 uptake imaging in eval uating the therapeutic result is much better than CT.