【摘要】 目的　主要对99mTc MIBISPECT脑胶质瘤显像与病理分级及肿瘤细胞核增殖抗原 (PCNA)之间的关系进行临床研究。方法　对 16例脑胶质瘤患者行99mTc MIBISPECT早期相和延迟脑断层显像。对早期相和延迟相显像分别作半定量分析。以得99mTc MIBI早期、延迟相摄取指数和滞留指数。所有患者手术切除标本切片行常规苏木精 伊红染色 ,并对切片行核增殖抗原 (PCNA)单克隆抗体免疫组化染色 ,以了解肿瘤细胞增殖状况。结果　病理诊断星型胶质细胞瘤 6例 ,间变性星型胶质细胞瘤 5例 ,多形性胶质母细胞瘤 5例。星型胶质细胞瘤、间变性星型胶质细胞瘤和多形性胶质母细胞瘤早期和延迟相99mTc MIBI摄取指数和滞留指数分别为 1.0 7± 0 .0 8,1.12± 0 .35 ,1.0 4± 0 .0 8;1.5 9± 0 .2 8,1.78± 0 .2 1,1.12± 0 .12 ;4.98± 1.2 5 ,7.5 3± 1.39,1.5 3± 0 .19。经统计学检验 ,星型胶质细胞瘤与多形性胶质母细胞瘤、间变性胶质细胞瘤和多形性胶质母细胞瘤的延迟相99mTc MIBI摄取指数和滞瘤指数差异均有显著性 ,P均 <0 .0 1。另对各组胶质细胞瘤的PCNA评分与99mTc MIBI滞留指数的相关系数进行计算 ,结果r =0 .747,P <0 .0 1。结论　99mTc MIBI脑胶质瘤SPECT可对术前肿瘤分级提供一定帮助。滞留指数可对肿瘤细胞的增殖活力?更多还原

【Abstract】 Objective To study the relationship between 99m Tc MIBI uptake and histopathologic grading and proliferation of glioma. Methods Early and delayed SPECT brain imaging were performed at 15 min and 3 hours after an intravenous injection of 1110 MBq of 99m Tc MIBI in 16 patients with glioma. Semiquantitative data were obtained as early and delayed uptake indexes and retention indexes (RI). Routine hematoxylin eosin stain was performed to confirm the diagnosis and PCNA immunohistochemical study. Results The pathologic diagnosis in six was astrocytoma and in five anaplastic astrocytoma and in another five glioblastoma multiforme. Early and delayed phase of 99m Tc MIBI SPECT imaging uptake index and RI were 1.07±0.08,1.12±0.35,1.04±0.08, respectively for astrocytoma. 1.59±0.28,1.78±0.21,1.122±0.12 for anaplastic and 4.98±1.25,7.53±1.39,1.53±0.19 for glioblastoma. There was significant difference in delayed uptake index and RI between astrocytoma and glioblastoma multiforme. So was those between anaplasitc astrocytoma and glioblastoma multiforme. The correlation coefficient between 99m Tc MIBI RI and PCNA was 0.747 for glioma. Conclusion glioma 99m Tc MIBI SPECT brain imaging does help in tumor grading prior to the operation. RI has an important value in predicting the tumor cell proliferative activity. (Shanghai Med J, 540 542)更多还原