早期鼻咽癌血管内皮细胞生长因子表达与肿瘤组织18F-FDG摄取的关系

目的 研究早期鼻咽癌组织血管内皮细胞生长因子(VEGF)表达及肿瘤组织~(18)F-FDG摄取的情况,并探讨早期鼻咽癌组织VEGF表达与~(18)F-FDG摄取的关系.方法 对40例I,II期鼻咽癌患者进行正电子发射体层显像检查,测定鼻咽原发灶肿瘤组织的~(18)F-FDG最大摄取值和标准摄取值(SUV_(max)和SUV_(mean)),应用标准链霉菌抗生物素蛋白-过氧化物酶亲和免疫组化法检测40例患者肿瘤组织VEGF的表达.结果 40例早期鼻咽癌组织的SUV_(max)>与SUV_(mean)分别为9.45±1.87和6.04±1.09,T_1期肿瘤原发灶SUV_(max)与SUV_(mean)分别为8.95±1.91和5.61±1.08,T_2期的原发灶SUV_(max)与SUV_(mean)分别为11.55±1.70和7.98±1.1,T_2期原发灶SUV_(max)和SUV_(mean)高于T_1期(t=4.46,P<0.001;t=6.763,P<0.001).非角化分化型肿瘤原发灶SUV_(max)与SUV_(mean)分别为9.74±1.82和6.82±1.23,非角化未分化型肿瘤原发灶SUV_(max)与SUV_(mean)分别为10.44±2.16和6.68±1.35,非角化分化型和非角化未分化型肿瘤原发灶SUV_(max)和SUV_(mean)无差别(t=1.230,P>0.05;t=0.346,P>0.05).40例鼻明癌组织VEGF染色阳性细胞率为60.8%;鼻咽癌组织FDG摄取(SUV_(max))和VEGF表达的细胞阳性率相关(r=0.460,P=0.03).结论 早期鼻咽癌组织FDG摄取与肿瘤组织VEGF过度表达相关,其SUV值反映了鼻咽癌组织的葡萄糖代谢情况,同时也在一定程度上反映了肿瘤组织乏氧的程度.

Abstract：

Objective To study the overexpression of vascular endothelial growth factor (VEGF) and fluorine-18 fluorodeoxyglucose (FDG) uptake in early-stage nasopharyngeal carcinoma (NPC) and evaluate their relationship. Methods FDG positron emission tomography (PET) was performed in forty patients with stage I and stage II NPC. The maximum and mean standard uptake values (SUV_(max) and SUV_(mean) ,respectively) were measured in each patient, and the expression of VEGF was measured on paraffin sections using immunohistochemistry. Results The FDG uptake in the patients were 9.45±1.87 (SUV_(max)) and 6.04±1.09 (SUV_(mean)), 8.95±1.91 (SUV_(max)) and 6.04±1.09 (SUV_(mean)) in stage I patients, and 11.55±1.70 (SUV_(max)) and 7.98±1.1 (SUV_(mean)) in stage II patients. The FDG uptake of stage II patients was higher than that of stage I patients. The FDG uptake of non-keratinizing differentiated carcinoma was 9.74±1.82 (SUV_(max)) and 6.82±1.23 (SUV_(mean)) and 10.44±2.16 (SUV_(max)) and 6.68±1.35 (SUV_(mean)) in non-keratinizing undifferentiated carcinoma, showing no significant differences between them (SUV_(max): t=1.230, P>0.05; SUV_(mean): t=0.346, P>0.05). The VEGF-positive cells were 60.80% in the tumor. A correlation between VEGF expression and FDG uptake in he tumor was noted (r=0.460, P=0.03). Conclusion VEGF overexpression is correlated to FDG uptake in patients with early-stage NPC. The SUV value reflects the glucose metabolism of NPC, and also shows the degree of oxygen insufficiency in the tumor tissue.     

Relationship between fluorodeoxyglucose uptake and overexpression of glucose transport protein 1 and hexokinase-Ⅱ in early-stage nasopharyngeal carcinoma

Objective To discuss the molecular mechanism of 18F-fluorodeoxyglucose (FDG) uptake in tumor and to assess its value to identify pathologic type and cancer staging in patients with earlystage nasopharyngeal carcinoma.Methods Forty patients with nasopharyngeal carcinoma of early-stage,including 12 cases with T1 stage and 28 cases with T2 stage, underwent FDG PET imaging.The maximum standardized uptake value ( SUVmax ) and mean standardized uptake value ( SUVmean ) of FDG uptake of each patient were measured and compared between T1 and T2 stage by t-test.The expression of glucose transport protein 1 ( Glut1 ) and hexokinase- Ⅱ ( HK- Ⅱ ) of each case was measured in paraffin sections by streptavidin-perosidase (SP) immunohistochemistry.The positive expression rate of Glut1 and HK- Ⅱ was calculated and compared between T1 and T2 by x2 test.Meanwhile, the correlation between the expression of Glut1 or HK-Ⅱ and the SUVmax was tested by Pearson analysis.Results The SUVmax and SUVmean in 40 patients were 9.45 ± 1.87 and 6.04 ± 1.09, respectively.The SUVmax of patients with T1 stage (8.95 ± 1.91 ) was significantly lower (t =4.46, P＜0.001 ) than that of patients with T2 stage (11.55 ± 1.70), and the SUVmean of patients with T1 stage (5.61 ± 1.08) was significantly lower ( t = 6.76, P ＜ 0.001 ) than that of patients with T2 stage (7.98 ± 1.10) too.Among 40 patients, all patients showed positive expression of Glut1 and HK-Ⅱ , and the positive expression rate of Glut1 and HK-Ⅱ was ( 45.2 ± 10.9 )% and ( 68.3 ±9.5)%, respectively.The positive expression rate of Glut1 was (38.4 ±8.1)% in T1 stage and (49.7 ±12.6)% in T2 stage, which displayed no difference (x2 =40.58, P＞0.05), but the HK-Ⅱ positive expression rate showed significant difference (x2 =58.71, P＜0.05) between T1 stage (60.1 ±11.1)% and T2 stage (77.9 ± 14.7 )%.The correlation analysis indicated that there was low-degree positive correlation (r =0.369, P=0.019) between the SUVmax and Glut1 expression, and there was medium-degree positive correlation (r = 0.549, P = 0.001 ) between the SUVmax and HK-Ⅱ expression.Conclusion Expression of Glut1 and HK-Ⅱ was positively correlated with FDG uptake in patients with early-stage nasopharyngeal carcinoma.     

早期鼻咽癌18F-FDG摄取与葡萄糖转运蛋白1及已糖激酶-Ⅱ过度表达的关系

目的 测定并分析早期鼻咽癌18F-脱氧葡萄糖（FDG）摄取与肿瘤组织葡萄糖转运蛋白1（Glut1）及己糖激酶-Ⅱ（HK-Ⅱ）的表达,以探讨鼻咽癌组织摄取FDG的分子机制及其与肿瘤病理类型和分期的相关性.方法 40例早期鼻咽癌患者（T1期12例,T2期28例）行PET检查,测定病灶最大标准摄取值（SUVmax）及平均标准摄取值（SUVmean） 行鼻咽部肿瘤活组织检查,并采用免疫组织化学法测定其Glut1及HK-Ⅱ表达,计算阳性细胞百分率.T1与T2期患者SUVmax或SUVmean间的差异采用t检验,Glut1及HK-Ⅱ表达阳性率差异采用x2检验,SUVmax与Glut1和HK-Ⅱ表达间的关系采用Pearson相关分析.结果 40例患者SUVmax与SUVmean分别为9.45±1.87和6.04±1.09.T1期分别为8.95±1.91和5.61±1.08,T2期分别为11.55±1.70和7.98±1.10,T1期与T2期相比原发灶SUVmax（t=4.46,P＜0.001）及SUVmean（t=6.76,P＜0.001）差异均有统计学意义.40例早期鼻咽癌患者Glut1及HK-Ⅱ染色均为阳性,阳性细胞率分别为（45.2±10.9）%与（68.3±9.5）%.其中Glut1阳性细胞率在T1期和T2期分别为（38.4±8.1）%与（49.7±12.6）%,两者差异无统计学意义（x2=40.58,P＞0.05）,而HK-Ⅱ阳性细胞率在T1期与T2期分别为（60.1±11.1）%与（77.9±14.7）%,差异有统计学意义（x2=58.71,P＜0.05））.SUVmax与Glut1表达阳性细胞率呈低度正相关（r=0.369,P=0.019）,与HK-Ⅱ表达阳性细胞率呈中度正相关（r=0.549,P=0.001）.结论 早期鼻咽癌组织FDG摄取与Glut1过度表达相关.     

131I-Herceptin的血液存在方式及体内外稳定性研究

目的 探讨131I-Herceptin的稳定性与生物学特性.方法 131I-H-Herceptin采用Iodogen法制备,其基础放射化学纯度(RCP)为(94.9+2.7)%.4℃冰箱内放置3、24、48、72、96 h,取各时间样品测RCP.取家兔5只,静脉注射131I-Herceptin后1 h、3 h、6h、24 h、2 d、3 d,4 d、5 d取血,分离血清及血细胞,测血清131I-Herceptin的RCP,并测定血清或血细胞放射性计数百分比.各组样品RCP的差异分析采用One-way Anova检验.结果 4℃放置72 h以内,RCP未见显著下降(F=15.985,P＜0.001);72 h后显著(t=9.971,P＜0.001)下降至(82.6±2.8)%.注射后1～96 h,131I-Herceptin主要存在于血清,其放射性所占比例稳定在81%～87%.注射体内后1 h,血清内131I-Herceptin的RCP为(90.9±8.5)%.未见显著差异(t=1.753,P＞0.05).24 h后为(75.4±3.9)%,提示开始显著降低(t=6.564,P＜0.001).结论 采用Iodogen法标记的131I-Herceptin,体外放置72h内,放射化学纯度基本稳定,注入体内后主要存在于血清,24h以内放射化学纯度稳定,24h后降解明显.     

干扰素-γ上调结直肠癌细胞系CEA表达的实验研究

背景与目的放射免疫治疗中肿瘤摄取标记抗体的量与肿瘤细胞靶位分子的表达量密切相关。本研究探讨不同浓度IFN-γ对结直肠癌细胞系CEA的诱导效应,以选择最适IFN-γ浓度上调结直肠癌细胞系CEA的表达及提高对131I-CL3结合率。方法取对数生长期结直肠癌细胞系LOVO和LS175T,实验组以终浓度为10、100、500、1000U/ml的IFN-γ诱导培养48h,对照组加入等量不含IFN-γ的培养液。各组2种细胞CEA的表达率及平均荧光强度(MFI)采用流式细胞仪(FACS)检测。结合法测定2种细胞诱导前后对131I-CL3的结合量(Ncpm)及结合率(BR)。细胞CEA表达率、MFI和BR的差异采用One-wayANOVA检验。结果LOVO与LS175T细胞CEA基础表达率分别为(75.6±6.8)%及(92.7±9.1)%,IFN-γ浓度在100U/ml以下时,LOVO细胞(F=2.689,P0.05)及LS175T细胞(F=2.107,P0.05)的CEA表达率均未见显著性增高。当IFN-γ浓度为500U/ml时,LOVO细胞CEA表达率(t=3.244,P0.05)及LS175T细胞MFI(t=5.810,P0.005)比对照组显著提高。IFN-γ浓度为500U/ml和1000U/ml两组之间,LOVO细胞CEA表达率(t=0.389,P0.05)及LS175T细胞CEA表达率(t=0.113,P0.05)未见显著差异。131I-CL3在LOVO与LS175T细胞的基础结合率分别为(22.1±2.4)%与(32.3±4.9)%。诱导后LOVO细胞增幅明显,倍增比(MR)为1.05～2.25倍,LS175T为1.11～1.56倍。在IFN-γ浓度为500U/ml时,LS175T细胞(t=4.988,P0.01)及LOVO细胞(t=9.262,P0.001)对131I-CL3的结合率均显著提高。结论IFN-γ可以上调结直肠癌细胞系CEA的表达,在一定范围内IFN-γ浓度与CEA表达率及对131I-CL3的结合量存在相关性。     

儿茶素对X射线全身照射小鼠的保护作用

目的探讨儿茶素对X射线全身照射小鼠的防护作用。方法采用6 MV X直线加速器一次性全身照射小鼠,药物加照射组以每日200 mg/kg儿茶素的剂量灌服动物10 d后施行照射。观察小鼠体重变化,外周血白细胞总数,平均存活时间,30 d生存率。结果药物加照射组小鼠体重减轻低于单纯照射组,平均生存时间明显长于单纯照射组,30 d存活率比单纯照射组明显升高,而且儿茶素能加快受照射小鼠外周血白细胞的恢复。结论儿茶素对X射线全身照射小鼠有明显的辐射防护作用。     

同时性多发结直肠癌的诊治分析

目的：探讨同时性多发结直肠癌的诊断与治疗,并进行临床分析。方法：对988例资料完整的初诊结直肠癌患者进行回顾性分析,根据癌灶数目、家族史、发病年龄等情况将988例患者分成单发性（结直肠单发癌）与多发性（同时性多发结直肠癌）两组,对两组数据进行统计学分析。结果：多发组38例,单发组950例;其中,多发组中2例患者为遗传性非息肉病性结直肠癌,并发癌主要为腺瘤恶变。多发组中的右半结肠癌占44.7%（17例）,高于单发组的22.7%（216例）;多发组共有癌灶79个,其癌灶的病理类型分别为腺瘤恶变10个、直肠类癌4个,其余65个均为腺癌;同时并发息肉者13例,占34.2%。随机抽查单发组的252例术前肠镜检查报告,发现同时并发息肉者39例,占15.4%,差异有统计学意义。多发组平均生存72.3个月,标准差为9.6个月,5年生存率为57.3%;单发组平均生存85.6个月,标准差为3.3个月,5年生存率为63%。结论：同时性多发结直肠癌多位于右半结肠,常并发腺瘤恶变,预后与单发癌患者相当。     

立体定向适形放疗治疗大肠癌肝转移10例报告

目的观察立体定向适形放疗治疗大肠癌肝转移的近期疗效及患者耐受性。方法１０例大肠癌肝转移在螺旋ＣＴ定位扫描后，采用Ｆｉｓｈｅｒ３ＤＴＰＳ设计治疗计划，Ｖａｒｉａｎ６００Ｃ直线加速器实施计划，９０％等剂量线包绕计划治疗体积（ＰＴＶ），ＤＴ：３６－４８Ｇｙ／５－７Ｆ／１０－１４Ｄ。结果放疗结束后３个月与放疗前比较，ＣＴ扫描肿瘤体积变化总有效率８９．５％（１７／１９）。放疗前后血象及肝功无显著变化（Ｐ＞００５）。结论立体定向适形放疗治疗大肠癌肝转移的近期疗效肯定，并且是一种安全的、无创的治疗方法。     

~(99)Tc~m-MIBI脑SPECT显像监测X刀治疗脑肿瘤疗效

立体定向Ｘ刀对颅内病灶的单次大剂量照射 ,已被认为是治疗脑肿瘤尤其是颅内中线深部结构及其附近病灶的有效方法[1] ,但治疗后单纯应用ＣＴ复查假阳性较多[2 ] 。笔者用99Ｔｃｍ 甲氧基异丁基异腈 (ＭＩＢＩ)对脑肿瘤进行断层显像 ,以评估Ｘ刀治疗脑肿瘤的疗效 ,现报道如下。资料与方法1.临床资料。对照组 15例 ,男 9例 ,女 6例 ,年龄 48～ 6 5岁 ,平均 5 6 5岁。脑肿瘤患者 49例 ,男 31例 ,女 18例 ,年龄 8～ 6 9岁 ,平均 5 1 5岁。其中原发性脑肿瘤 2 0例 ,转移性脑肿瘤 2 9例 ;属单发病灶 36例 ,多发病灶 13例 ,共 71个病灶。Ｘ刀治疗…