Liang Ji-An, Shiau Yu-Chien, Yang Shih-Neng, Lin Fang-Jen, Kao Albert, Lee Cheng-Chun
Department of Radiation Therapy and Oncology, China Medical College Hospital, Taichung, Taiwan.
Jpn J Clin Oncol. 2002 Apr;32(4):140-5. doi: 10.1093/jjco/hyf027.
The purpose of this study was to predict chemotherapy response in untreated malignant lymphomas using technetium-99m methoxyisobutylisonitrile (Tc-MIBI) scan.
Twenty-five patients with malignant lymphoma were studied before receiving chemotherapy. Early Tc-MIBI scan was performed 10 min after intravenous injection of Tc-MIBI. Immunohistochemical analyses were performed on multiple non-consecutive sections of the biopsy specimens to determine Pgp expression. Chemotherapy response was evaluated in the first 1-2 years after completion of treatment by clinical and radiological methods.
The mean tumor-to-background ratio of the 15 patients with good response (3.3 +/- 0.6) was significantly higher than that of the 10 patients with poor response (1.2 +/- 0.1). Among the 15 patients with good response to chemotherapy, all had positive Tc-MIBI scan results but negative Pgp expression. Among the 10 patients who had poor response to chemotherapy, all 10 had negative Tc-MIBI scan, but six patients had positive Pgp expression and four had negative Pgp expression. Significant differences were found in the incidences of good and poor responses determined by Tc-MIBI scan and Pgp expression. However, there were no significant differences in the incidences of good and poor responses for other prognostic factors.
Compared with other prognostic factors, early Tc-MIBI scan more accurately predicts chemotherapy response in patients with malignant lymphoma.
本研究的目的是使用锝-99m 甲氧基异丁基异腈(Tc-MIBI)扫描预测未经治疗的恶性淋巴瘤的化疗反应。
对 25 例恶性淋巴瘤患者在接受化疗前进行研究。静脉注射 Tc-MIBI 10 分钟后进行早期 Tc-MIBI 扫描。对活检标本的多个非连续切片进行免疫组织化学分析以确定 Pgp 表达。在治疗完成后的前 1 - 2 年通过临床和影像学方法评估化疗反应。
15 例反应良好患者的平均肿瘤与背景比值(3.3 ± 0.6)显著高于 10 例反应较差患者的平均肿瘤与背景比值(1.2 ± 0.1)。在 15 例对化疗反应良好的患者中,所有患者的 Tc-MIBI 扫描结果均为阳性,但 Pgp 表达为阴性。在 10 例对化疗反应较差的患者中,所有 10 例患者的 Tc-MIBI 扫描均为阴性,但 6 例患者 Pgp 表达为阳性,4 例患者 Pgp 表达为阴性。通过 Tc-MIBI 扫描和 Pgp 表达确定的良好和不良反应发生率存在显著差异。然而,其他预后因素的良好和不良反应发生率没有显著差异。
与其他预后因素相比,早期 Tc-MIBI 扫描能更准确地预测恶性淋巴瘤患者的化疗反应。