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以延迟相葡萄糖负荷的FDG PET/CT扫描方法预测高血糖对多药耐药蛋白和P-糖蛋白活性影响的可行性
引用本文:金仲慧,吕忠文,朱慧慈,刘君,何平,李欣欣,宋乐,刘玉良.以延迟相葡萄糖负荷的FDG PET/CT扫描方法预测高血糖对多药耐药蛋白和P-糖蛋白活性影响的可行性[J].吉林大学学报(医学版),2015,41(1):125-128.
作者姓名:金仲慧  吕忠文  朱慧慈  刘君  何平  李欣欣  宋乐  刘玉良
作者单位:1. 北京大学第三医院核医学科, 北京 100191;
2. 吉林大学中日联谊医院放射线科, 吉林 长春 130033
基金项目:国家高技术研究发展计划(863计划)项目资助课题(2007AA03Z320)
摘    要:目的: 通过PET/CT延迟相葡萄糖负荷观察18F-氟代脱氧葡萄糖(18F-FDG)排出细胞的关键酶--多药耐药蛋白(MRP)和P-糖蛋白(P-gp)的活性是否与血糖水平有关,初步阐明其可能机制。方法: 随机选取12例恶性肿瘤患者序贯进入实验组,并在病历库中随机选取同期30例常规双时相扫描患者为对照组。2组患者早期相均为常规空腹18F-FDG PET/CT扫描,延迟相实验组患者口服葡萄糖后扫描,对照组患者则不口服葡萄糖。记录并分析2组患者早期相和延迟显像中肿瘤组织和健康组织标准化摄取比值(SUV)的变化。结果: 2组患者延迟相各感兴趣区(ROI)的平均SUV(SUVmean)和最大SUV(SUVmax)变化,与早期相比较,对照组患者肿瘤延迟相SUVmax明显升高(P<0.01),竖脊肌延迟相SUVmean变化不明显(P>0.05),肝脏、主动脉延迟相SUVmean明显减低(P<0.01);与早期相比较, 实验组患者竖脊肌延迟相SUVmean明显升高(P<0.05),而肿瘤延迟相SUVmax变化不明显(P>0.05),肝脏和主动脉延迟相SUVmean明显减低(P<0.01)。结论: 葡萄糖负荷后肿瘤组织SUV未出现明显升高,提示18F-FDG排出与进入细胞的速度取得了新的平衡,预示高血糖可能导致MRP和P-gp功能的上调或激活。

关 键 词:18F-氟代脱氧葡萄糖  PET/CT  葡萄糖负荷  糖尿病  恶性肿瘤  预后  
收稿时间:2014-06-27

Feasibility of glucose loading at delayed phase of FDG PET/CT scaning in predicting influence of hyperglycemia in multi-drug resistance protein or P-glycoprotein
JIN Zhonghui,LYU Zhongwen,ZHU Huici,LIU Jun,HE Ping,LI Xinxin,SONG Le.Feasibility of glucose loading at delayed phase of FDG PET/CT scaning in predicting influence of hyperglycemia in multi-drug resistance protein or P-glycoprotein[J].Journal of Jilin University: Med Ed,2015,41(1):125-128.
Authors:JIN Zhonghui  LYU Zhongwen  ZHU Huici  LIU Jun  HE Ping  LI Xinxin  SONG Le
Institution:1. Department of Nuclear Medicine, Third Hospital, Peking University, Beijing 100191, China;
2. Department of Radiology, China-Japan Union Hospital, Jilin University, Changchun 130033, China
Abstract:Objective To find out whether there is relationship between hyperglycemia and activities of multi-drug resistance protein (MRP) or P-glycoprotein (P-gp) which are the key enzymes of 18F-FDG extraction out of cells through the method of glucose loading at delayed phase of PET/CT scaning, and to clarify its possible mechanism. Methods 12 patients with malignant tumor were randomly selected to the experimental group, as a control, 30 cases of conventional dual phase scan were randomly selected into control group.The patients in groups received routine fasting early phase PET/CT scan, and the delayed scan in experimental group was performed after orally taken glucose, whereas in control group, there was not any glucose or sugar taken.The standardized uptake values (SUV) of early and delayed imaging of tumor and healthy tissues in two groups were recorded and analyzed. Results The SUV changes of each ROI between two phases at control group: the SUVmax of tumors was increased obviously at delayed phase (P<0.01);the SUVmean of musclus erector spinae wasn't increased obviously at delayed phase(P<0.05), the SUVmean of live (P<0.01) and aorta (P<0.01) were decreased obviously at delayed phase.However, in experimental group, the SUVmean of musculus erector spinae was increased obviously at delayed phase(P<0.05);the SUVmax of tumors wasn't increased obviously at delayed phase (P<0.05), which were different with control group; whereas the SUVmean of live (P<0.01) and aorta (P<0.01) were also decreased obviously at delayed phase. Conclusion The SUV in tumor tissue isn't increased significantly after glucose loading, which indicates that a balance of 18F-FDG discharging and entering the tumor cells is obtained and illustrates that hyperglycemia might induce the up-regulation or activation of MRP or P-gp.
Keywords:18 F-fluorodeoxyglucose  PET/CT  glucose loading  diabetes mellitus  malignant tumor  prognosis
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