中文摘要：

目的 通过与^18F-FDGPET/CT比较,前瞻性评估整合素ctvp3受体显像^99mTc-3ffiGD2SPECT/CT对非小细胞 肺癌诊断及淋巴结分期的价值.方法前瞻性纳人2011年2 月至2012年 12月北京协和医院知情同意参与研究的6 5例肺 占位病变患者.其中男41例,女2 4例,平均年龄（ 60 ± 11 ）岁.患者在1 周内分别行^99mTc-3PRGD2SPECT/CT和1SF- FDGPET/CT检查.完成病理诊断后,随访至死亡或随访至少2年.用受试者工作特征曲线、Z 检验、卡方检验比较两种 方法对肺内病灶及纵隔淋巴结的诊断效能.结果 5 3例患者共65个病灶经病理证实为非小细胞肺癌,12例患者共14个 病灶诊断为良性病变.基于美国癌症联合委员会/ 国际抗癌联盟纵隔分区,248个区域有肿瘤转移淋巴结,5 6个区域有良 性淋巴结.在诊断纵隔淋巴结转移方面,^99m（Tc-3PRGD2 SPECT/CT特异性显著高于^18F-FDG PET/CT（94 .6% 比75.0%, P= 0.008）,而两者的敏感性差异无统计学意义（ 88 .3%比90. 7% ,P= 0.557）.两种方法对肺内病变的诊断效能差异无 统计学意义（Z = 0.82,P = 0.410）.结论整 合素受体显像^99mTc-3PRGD2SPECT/CT在诊断淋巴结转移方面具有较高的特 异性,可能弥补1SF-FDGPET/CT的不足,在肺癌手术决策方面具有更大价值.

英文摘要：

Objective To prospectively evaluate the value of integrin a vp3 receptor imaging approach based on single photon emission computed tomography/computed tomography （SPECT/CT） , using ^99mTc-3PRGD2 as the tracer, in diagnosis and staging of non-small cell lung cancer （ NSCLC） compared with 18 F-FDG positron emisson tomography/computed tomography （PET/CT）. Methods From February 2011 to December 2012 , 65 patients with suspicious lung lesions were recruited with informed consent in Peking Union Medical College Hospital, including 41 males and 24 females,with a mean age of （ 60 ± 11 ） years. The patients under-went both ＂mTc-3PRGD2 SPECT/CT and 18 F-FDG PET/CT within one week. After pathological diagnosis, all the patients were followed up until death or for at least two years. Receiver operating characteristic （ROC） curve, Z test, and Chisquare test were used to compare the diagnostic performance of the two imaging methods in assessing lung lesions and mediastinal lymph nodes. Results Sixty-five lung lesions in 53 patients were pathologically diagnosed as NSCLC, and 14 lung lesions in 12 patients were proved as benign. Based on the American Joint Committee on Cancer/Union for International Cancer Control （AJCC- UICC） stand-ard, 248 regions of lymph nodes had metastasis and 56 were negative regions. ^99mTc-3PRGD2 SPECT/CT was found to have higher specificity compared with 18 F-FDG PET/CT in the perregion diagnosis of lymph node metastasis （94. 6% vs. 75. 0% , P = 0. 008） , whereas the sensitivity of the two methods showed no statistically significant difference （88. 3% vs. 90. 7 % , P = 0. 557）. There was no significant difference between the two methods in diagnostic performance for lung lesion （ Z = 0. 82, P = 0. 410）. Conclusion ^99mTc-3PRGD2 SPECT/CT shows high specificity in the diagnosis of lymph node metastasis from NSCLC, which may complement 18 F-FDGPET/CT in diagnosis and benefit surgical deci