99Tcm-depreotide显像对肺部病灶的鉴别诊断价值

The clinical value of 99Tcm-depreotide scintigraphy in differentiating malignant from benign lesions in the lung

  • 摘要: Depreotide是一种人工合成的十肽生长抑素类似物,含生长抑素受体结合序列和99Tcm配位序列.通过荟萃分析肺部病灶的99Tcm-depreotide显像资料显示,99Tcm-depreotide鉴别肺部病灶良恶性的灵敏度为94.2%(95%可信区间:90.5%,97.9%),特异度为61.2%(95%可信区间:50.7%,71.7%),诊断准确率为81.6%,阳性预测值为81.1%,阴性预测值为83.2%;对于1.5 cm以下的孤立性肺结节(SPN),99Tcm-depreotide显像特异性极高,显像阳性是手术治疗的适应证;对于1.5 cm以上的SPN,因其灵敏度高,99Tcm-depreotide显像阴性者可进行系列CT扫描随访观察.

     

    Abstract: Depreotide is a synthetic 10-aminoacid peptide which is comprised of a somatostain receptor binding sequence and a technetium coordinating sequence. A meta-analysis is performed to estimate the diagnostic efficiency of 99Tcm-depreotide scintigraphy. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 99Tcm-depreotide SPECT in distinguishing pulmonary lesions were, respectively, 94.2% (95% confidence interval (CI):90.5%, 97.9%), 61.2% (95% CI:50.7%,71.7%), 81.6%, 81.1% and 83.2%. In patients with a small solitary pulmonary nodule (<1.5 cm) and positive 99Tcm-depreotide SPECT, the risk of malignancy is high. On the other hand, patients with a large solitary pulmonary nodule (>1.5 cm) and a negative scan may be recommended for serial CT follow-up, since the sensitivity in those subjects was high.

     

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