论文标题:～（99m）Tc-MIBI联合CT、肿瘤标志物检测肺结节及～（99m）Tc-MIBI监测肺癌疗效的意义
～(99m)Tc-MIBI Combined with CT and Serum Tumor Markers Detect Pulmonary Nodules and Monitor Chemotheraputic and Radiotherapeutic Response of Lung Cancer by ～(99m)Tc-MIBI
论文作者 余勇
论文导师 胡筠珠,论文学位 硕士,论文专业 内科学
论文单位 苏州大学,点击次数 91,论文页数 33页File Size1969k
2003-04-01论文网 http://www.lw23.com/lunwen_82925267/ 肺癌,99mTc-MIBI,CT,肿瘤标志物
lung cancer,~(99m)Tc-MIBI,CT,serum tumor markers
目的： 探讨~(99m)Tc-MIBI肺亲肿瘤显像与CT、肿瘤标志物测定相结合在鉴别诊断肺部良恶性结节中的价值及~(99m)Tc-MIBI显像在监测肺癌治疗效果中的意义。 方法： 对50例胸片发现肺部结节的患者行~(99m)Tc-MIRI肺亲肿瘤显像、X-CT肺扫描及肿瘤标志物测定(包括CEA、NSE、CYFRA21-1，采用化学发光法、酶联免疫吸附法和放射免疫法测定)，分别计算出三种方法在鉴别诊断肺部结节中的灵敏度、特异性、准确性，再将三种方法联合应用于肺部结节的诊断，计算其灵敏度、特异性、准确性，确定三法联合使用的临床价值。 结果： 1．三法联合使用与单用99mTc-MIBI肺显像相比，灵敏度、准确性均提高(P＜0.05)，而特异性无显著差异。 2．三法联合使用与单用X-CT肺扫描相比，特异性提高(P＜0.05)，而灵敏度、准确性无显著差异。 3．三法联合使用与单用肿瘤标志物相比，无论灵敏度(P＜0.01)、特异性(P＜0.05)、准确性(P＜0.05)均提高。 4．肺癌患者化疗前行99mTc-MIBI肺显像，若99mTc-MIBI吸收比越高，则化疗效果越好。 5．肺癌患者化疗前后各行一次99mTc-MIBI肺显像，若化疗后MIBI吸收比较化疗前下降越大，则化疗效果越好。99mTc一MIBI联合cT、肿瘤标志物检测肺结节及，灿Tc一MIBI监测肺癌疗效的意义结论:1.99mTc一MIBI肺显像与CT、肿瘤标志物测定三法联合使用在肺部良恶性结节鉴别诊断中的价值较任何单一应用为大。2.99mTc一MIBI肺显像是监测肺癌化疗效果的有效方法。
Object:To discuss that 99mTc-MIBI combined with CT and serum tumor markers to detect pulmonary nodules and monitor chemotheraputic and radiotherapeutic response of lung cancer by 99mTc-MIBI.Methods:50 patients who X-ray indicated suspected nodules underwent 99mTc-MIBI, X-CT and the detection of serum tumor markers (includeCEA, NSE, CYFRA211, measured with chromatometry chemoluminescenceN ELISA and RIA), calcuate the sensitivity, specificity and accuracy respectively, then combined three methods to detect the pulmonary nodules, calcuate sensitivity, specificity and accuracy again, to determine the clinical value of combined three methods.Rusult:1.compared with 99mTc-MIBI,combined detection with three methods increased sensitivity and accuracy (P<0.05), but specificity had no significant statistically difference.2. compared with X-CT, combined detection increased specificity (P<0.05), but sensitivity and accuracy had no significant statistically difference.3. compared with serum tumor markers, combined detection not only increased sensitivity, specificity (P<0.05), but also accuracy (P<0.05) .4.If the patients with lung cancer underwent 99mTc-MIBI before chemotherapy, we found that the higher the T/N is,the better chemotheraputic response is obtained.5. If the patients with lung cancer underwent 99mTc-MIBI before and after chemotherapy, we found that the more T/N percentage decreased, the better chemotheraputic response is obtained.Conclusion:1.99mTc-MIBK X-CT, serum tumor markers, three methods were combined to detect benign and malignant pulmonary nodules is better than that only use one method.2.99mTc-MIBI is a useful method for monitoring the chemotheraputic response of lung cancer.
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