摘要
目的:探讨99Tcm-HYNIC-PEG4-E[PEG4-c(RGDfk)]2(99Tcm-3P4-RGD2)显像探测肺癌骨骼转移灶的临床应用价值。方法:回顾性分析2012年7月—2013年9月45例经病理证实的肺癌患者,所有患者均接受99Tcm-3P4-RGD2显像(RGD显像,包括平面和断层显像)、99Tcm-MDP显像(MDP显像,包括平面和断层显像),同时行SPECT-CT融合显像。所有病灶均以病史、病理检查或6个月以上的影像学随访为最终诊断结果。探讨RGD显像对肺癌骨骼转移病变的诊断效能。结果:45例肺癌并发骨骼病灶122处,成骨性转移病灶102处,溶骨性病灶20处(其中5处尚未出现明显骨质密度改变),良性骨病变51处。溶骨性转移灶对99Tcm-3P4-RGD2摄取(T/NT:6.90±2.31)显著高于99Tcm-MDP(1.18±1.24,P=0.010),RGD显像对溶骨性、成骨性转移灶的探测灵敏度(84.8%和55.9%)分别与MDP显像(25.0%和91.2%)差异显著(P均<0.05),融合CT显像后,两种显像方法对骨转移的诊断特异性无统计学差异,但MDP融合显像对骨转移灶的探测灵敏度(92.6%)和准确性(93.4%)均高于RGD融合显像(78.7%,P=0.008;80.3%,P=0.010)。另外,RGD融合显像可对骨骼病变原发肺癌灶和其他转移灶进行有效探测。结论 :99Tcm-3P4-RGD2靶向结合肿瘤细胞、破骨细胞的整合素αvβ3受体,在肺癌溶骨性骨转移的早期发现中具有一定优势,是常规骨显像的有效补充。
Objective：To investigate the value of imaging with99Tcm-HYNIC-PEG4-E [PEG4-c（RGDfk）]2（99Tcm-3P4-RGD2） as radiotracer in the dectection of lung cancer bone metastases. Methods： A total of 45 patients（25 males and 20 females） with lung cancer were retrospectively studied in our hospital from July 2012 to September 2014. All patients received99Tcm-3P4-RGD2imaging（RGD imaging,including plane and tomography） and99Tcm-MDP imaging（MDP imaging,including plane and tomography）,meanwhile undergoing SPECT-CT fusion imaging. The final diagnosis was made based on history, pathology,and 6 months follow-up. RGD imaging in the diagnosis of lung cancer with bone metastasis lesions was investigated. Results：Within 122 bone metastasic lesions,102 was osteolytic, 20 was osteoblastic metastases（5 were demonstrated no bone density changes）and there were 51 benign bone lesions. Regional accumulation of99Tcm-3P4-RGD2（T / NT：6.90 ± 2.31） was higher than that of99Tcm-MDP（1.18 ± 1.24,P=0.010）.The diagnotic sensitivity of RGD imaging to osteolytic metastases was 84.8%, higher than that of MDP imaging（25.0%） while the diagnostic sensitivity of RGD imaging to osteoblastic metastases was 55.9%, lower than that of MDP imaging（91.2%）（both P〈0.05）. When combined with 6 slice-CT imaging, the diagnostic specificity difference of bone metastases between RGD fusion imaging and MDP fusion imaging was insignificant. The diagnostic sensitivity and accuracy of MDP fusion imaging（92.6% and93.4%） were higher than those of RGD fusion imaging（78.7%,P =0.008;80.3%,P =0.010）. Furthermore, RGD imaging also detected primary lung cancer and lymph node metastases. Conclusion： Specifically targeting integrin αvβ3, which was highly ex-pressed on osteoclast and lung cancer cells,99Tcm-3P4-RGD2 imaging has great potential for detection of lung cancer osteolytic metastasis.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2015年第11期1659-1663,共5页
Journal of Nanjing Medical University(Natural Sciences)
基金
江苏省自然科学基金(BK20130082)
南京市杰出青年基金课题(JQX14049)
