~(99m)Tc-HL91乏氧显像对胃癌血管正常化窗口的判断

目的 探讨~(99m)Tc-HL91乏氧显像在胃癌血管正常化窗口(NWTV)的监测与判断中的价值.方法 使用~(99m)Tc-HL91对40只裸鼠肿瘤组织行乏氧显像,随机将裸鼠分成治疗组(n=20)按400 μg/每次腹腔注射DC101与对照组(n=20)注射同体积的生理盐水,利用感兴趣区(ROI)技术计算出注射后5 min到8 h的靶和非靶组织放射性比值(T/NT),取最大T/NT代表肿瘤乏氧状态,与对照组比较动态监测抗鼠血管内皮细胞生长因子受体2的单克隆抗体(DC101)治疗后1～14 d的胃癌乏氧变化并定位NWTV.结果 对照组开始显影时间和达到最大T/NT时间在第1～14天间无明显区别,治疗组第1天肿瘤显影时间为(30.12±0.11)min,T/NT峰值时间为(6.26±0.36)h.第2天起肿瘤显像时间和T/NT峰值时间逐渐减少,至第5天后与对照组间无明显区别.与对照组肿瘤乏氧逐渐缓慢增加不同,治疗组肿瘤乏氧呈波浪式增加.DC101治疗后第2天肿瘤乏氧(6.23±0.26)下降,到第5天肿瘤乏氧(0.24±0.14)几乎消失,在第8天(6.36±0.14)再次开始逐渐增加,NWTV出现在DC101治疗后第2天至第8天.结论 ~(99m)Tc-HL91乏氧显像能无损伤性监测抗血管生成治疗后肿瘤的乏氧变化,精确定位胃癌的NWTV.

The diagnostic value of ~(99m)Tc-HL91 hypoxia imaging in normalization window of gastric cancer vas-culature

Objective To evaluate the diagnostic value of ~(99m)Tc-HL91 hypoxia imaging in normali-zation window of tumor vasculature (NWTV). Methods Forty nude mice with transplanted gastric HS-746T cell line carcinoma were subjected to ~(99m)Tc-HL91 hypoxia imaging. Nude mice were randomly divided into treatment group (n=20,400 μg/each intraperitoneal injection of DC101) and control group (n = 20, injection of the same volume of saline). From 5 min to 8 h after injection the radioactivity ratio of tumor to normal tissues (T/NT) was calculated using the region of interest (ROI) technique, and the maximum ra-tio of T/NT was taken to represent the tumor hypoxia. As compared with control group at 1 to 14 days post-treatment with monoclonal antibody against vascular endothelial growth receptor 2 (DC101 ), the change in hypoxia of tumor was dynamically monitored. As compared with the hypoxia of untreated nude mice, the accurate diagnosis of NWTV was made. Results At the first day after injection of ~(99m)Tc-HL91 the tumor began to visualization at (5.46±0. 24) min in control group, and the ratio of T/NT reached the maximum at (3.24 ±0. 18) h. Whereas, those in treatment group were (30. 12±0. 11 ) min and (6. 26±0. 36) h respectively. In control group, there were no significant differences in visualization time and peak time of T/NT by 14 days. However, in the treatment group, the initial hypoxia imaging time and peak time of T/NT was decreased gradually at the second day. The visualization time [(5.32±0. 14) min vs (5.39± 0. 35 ) min, P > 0. 05] and peak time of T/NT [(3.34 ± 0. 26) h vs (3.28 ± 0. 27) h, P > 0. 05] had no difference between the treatment and the untreated groups at the 5th day. As compared with the smooth in-crease of hypoxia in control group, those in treatment group were increased wave-hkely. After DC101 treat-ment, tumor hypoxia began to drop on the day 2 (6. 23 ±0. 26), almost abolished on the day 5 (0. 24± 0. 14), and increased again by the day 8 (6. 36±0. 14). The NWTV emerged from the 2ad day to 8th day after DC101 treatment. Conclusion Hypoxia imaging of ~(99m)Tc-HL91 was a potential non-invasive tool in monitoring the hypoxia of tumor after anti-angiogenesis and in the accurate diagnosis of the NWTV.