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目的 用67Ga显像预测和监测非霍奇金淋巴瘤 (NHL)治疗后的早期疗效。方法 86例治疗前67Ga显像和CT扫描阳性的淋巴瘤患者 ,经临床和病理检查证实为NHL。平面67Ga显像分别在治疗后 2和 4个疗程进行。有 5 1例患者治疗 4个疗程后进行CT扫描。患者经 4个疗程治疗后 ,平均随访时间为 1.5年 (3～ 30个月 )。治疗效果评价 :①完全有效 :病灶不显影 ;②部分有效 :病灶部分显影 ;③无效 :病灶显影无变化或进一步增大。结果 86例患者中 6 1例67Ga显像示治疗完全有效 ,14例部分有效 ,11例治疗无效。随访中 ,早期67Ga显像阴性预测值 90 % (4 3/ 48例 ) ,晚期67Ga显像阴性预测值 6 9% (9/ 13例 ) ,提示前者更有临床价值。病灶部分消失和无变化者 ,阴性预测值仅36 % (9/ 2 5例 ) ,提示这部分患者预后很差。CT结果 :治疗后 ,5 1例患者中 18例阴性 ,33例阳性 ,随访中 ,阴性预测值 6 7% (12 / 18例 ) ,而阳性预测值为 2 7% (9/ 33例 )。表明67Ga显像能有效预测疗效 (P<0 .0 0 1) ,而CT则不能 (P >0 .0 5 )。结论 治疗后早期67Ga显像对预测和检测NHL疗效优于晚期显像 ,对患者治疗疗效的评价明显优于CT。
Objective To predict and monitor the early effect of non-Hodgkin’s lymphoma (NHL) with 67Ga imaging. Methods Totally 86 cases of lymphoma with positive 67Ga imaging and CT scan before treatment were confirmed as NHL by clinical and pathological examination. Plane 67Ga imaging were performed 2 and 4 courses after treatment. Fifty-one patients underwent CT scan after 4 courses of treatment. After 4 courses of treatment, the average follow-up time was 1.5 years (range 3-30 months). Therapeutic effect evaluation: ① completely effective: the lesion does not develop; ② part of the effective: partial development of the lesion; ③ invalid: no change in the development of lesions or further increase. Results Sixty-six cases of 67Ga imaging in 86 patients showed complete and effective treatment, 14 cases were partially effective and 11 cases were ineffective. During the follow-up, the negative predictive value of early 67Ga imaging was 90% (43/48), while the negative predictive value of 67Ga imaging was 69% (9/13), suggesting that the former has more clinical value. The disappearance of the lesion and no change, negative predictive value was only 36% (9/25), suggesting that this part of the patients with poor prognosis. CT results: After treatment, 18 of 51 patients were negative and 33 were positive. At follow-up, the negative predictive value was 67% (12 of 18 cases), while the positive predictive value was 27% (9 of 33 cases). The results show that 67Ga imaging can effectively predict the effect (P <0. 001), while CT can not (P> 0.05). Conclusion Early postoperative 67Ga imaging is superior to late stage imaging in predicting and detecting NHL. The evaluation of therapeutic effect is superior to CT.