摘要
目的:探讨^(99m)Tc-HL91检测宫颈癌乏氧状态及构建生物学靶区的临床应用效果。方法:选取2016年1月-2016年12月本院收治的ⅠB~ⅡA期宫颈癌可手术患者60例作为研究对象,按照信封法随机将其分为A组(n=30)和B组(n=30)。A组采用手术+术后放疗治疗,术前^(99m)Tc-HL91检测勾画乏氧感兴趣区(ROI),术中采用微电极法(金标准)检测肿瘤乏氧区的氧分压(PaO_2),验证^(99m)Tc-HL91检测结果的准确性。B组采用术前放疗+手术治疗,术前放疗中行^(99m)Tc-HL91检测获取肿瘤/正常宫颈组织(T/NT)值,术后均随访1年,统计随访期间宫颈癌复发情况,并分析患者T/NT值与其随访期间复发率之间的关系。结果:A组27例患者乏氧显像阳性,病灶乏氧检查阳性率为90.00%(27/30),PaO_2≥30 mmHg(乏氧阴性)和PaO_2<30 mmHg(乏氧阳性)比例分别为6.67%(2/30)和93.33%(28/30),^(99m)Tc-HL91检测宫颈癌乏氧状态的敏感度、特异度、准确性以及Kappa值分别为96.43%、100%、96.67%和0.783,其检测宫颈癌乏氧状态的价值良好。B组放疗前、放疗至20和40 Gy的T/NT值分别为(1.68±0.25)、(1.85±0.28)和(2.02±0.33),放疗期间T/NT值不断升高,肿瘤乏氧状态得以不断缓解,随访期间宫颈癌复发率为23.33%(7/30),且复发患者放疗前、放疗至20和40 Gy的T/NT值与无复发患者比较均降低,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,B组放疗前、放疗至20和40Gy的T/NT值与其宫颈癌复发率均呈负相关(r=-0.855、-0.872、-0.816,P<0.05)。结论:^(99m)Tc-HL91检测宫颈癌乏氧状态良好且T/NT值与其预后相关,T/NT值检测有可能作为其预后早期评估的参考指标。
To investigate the clinical effect of99mTc-HL91in detecting hypoxic state of cervicalcancer and constructing biological target area.Method:A total of60patients with stageⅠB-ⅡA cervical cancerwho could be operated in our hospital from January2016to December2016were selected as the study objects.According to the envelope method,they were divided into group A(n=30)and group B(n=30).Group A wastreated with surgery+postoperative radiotherapy,preoperative99mTc-HL91detection was used to outline hypoxiaarea of interest(ROI),and intraoperative microelectrode method(gold standard)was used to detect oxygen partialpressure(PaO2)in hypoxia area of tumor to verify the accuracy of99mTc-HL91test results.Group B was treatedwith preoperative radiotherapy+surgery,preoperative radiotherapy was undergone99mTc-HL91detection for tumor/normal cervical tissues(T/NT)value,and patients were followed up for at least1years.The recurrence rate of cervical cancer of group B during follow-up,and relationship between T/NT value of group B with the recurrence rate in follow-up were analyzed.Result:There were27patients with hypoxia imaging positive in group A,the positive rate of hypoxia detection was90%(27/30),the PaO2≥30mm Hg(hypoxic negative)and PaO2<mm Hg(hypoxic positive)ratio were6.67%(2/30)and93.33%(28/30)respectively,and the sensitivity,specificity,accuracy and Kappa value of99mTc-HL91in detecting cervical cancer hypoxic state were96.43%,100%,96.67%and0.783respectively,which meant that the value of99mTc-HL91in detecting cervical cancer hypoxic state was excellent.Before radiotherapy,20and40Gy radiotherapy of T/NT values in group B were(1.68±0.25),(1.85±0.28)and(2.02±0.33)respectively,the T/NT values increased continuously and the hypoxic state of the tumor was relieved continuously during radiotherapy.The recurrence rate of cervical cancer during followup period was23.33%(7/30).The T/NT values of patients with recurrence before radiotherapy,20and40Gy radiotherapy were lower than those of patients without recurrence,the differences
作者
钟久鸿
钟小军
张伟云
黄松
张庆
陈琦
郭宇玲
彭小东
游震宇
ZHONG Jiuhong;ZHONG Xiaojun;ZHANG Weiyun(The First Affiliated Hospital of Nanchang University,Nanchang 330000,China)
出处
《中国医学创新》
CAS
2018年第25期18-21,共4页
Medical Innovation of China
基金
江西省教育厅科学技术研究项目(150248)
