Comparison of technetium-99m tetrofosmin and gallium-67 citrate scintigraphy for detecting malignant lymphoma

The aim of this study was to compare the value of technetium-99m tetrofosmin (Tc-TF) scintigraphy with that of gallium-67 citrate (Ga-67) scintigraphy for detecting malignant lymphoma. In this study, 50 patients with malignant lymphoma underwent Tc-TF and Ga-67 scintigraphy before receiving any therapy. Tc-TF scintigraphy detected malignant lymphoma in 44 (88%) patients, but was false-negative in 4 cases of infradiaphragmatic malignant lymphoma and in 2 cases of malignant lymphoma with chemotherapy resistance. Ga-67 scintigraphy detected malignant lymphoma in 45 (90%) patients, but was false-negative in 3 cases of low-grade non-Hodgkin's lymphoma and in 2 cases of malignant lymphoma with bone marrow involvement. There was no significant difference in sensitivity between Tc-TF and Ga scintigraphy. However, a combination of Tc-TF and Ga-67 scintigraphy detected malignant lymphoma in all 50 patients (100%). We conclude that it is necessary to combine Tc-TF and Ga-67 scintigraphy to accurately detect malignant lymphoma.     

Predicting chemotherapy response and comparing with P-glycoprotein expression using technetium-99m tetrofosmin scan in untreated malignant lymphomas

The purposes of this study were to predict the chemotherapy response of untreated malignant lymphomas (ML) using a technetium-99m tetrofosmin (Tc-TF) scan and to compare Tc-TF results with P-glycoprotein (Pgp) expression. Before undergoing chemotherapy, 25 patients with ML were enrolled in this study. Tc-TF scan was performed 10 min after intravenous injection of Tc-TF. Immunohistochemical analyses were performed on multiple sections of ML specimens to evaluate Pgp expression. The chemotherapy response was evaluated in the first 1–2 years after the completion of treatment. The mean tumor-to-background ratio of the 15 patients with good responses (3.23±0.56) was significantly higher than that of the ten patients with poor responses (1.18±0.11). All of the 15 patients with good responses had positive Tc-TF scan results, but negative Pgp expression. Among the ten patients with poor responses, all had negative Tc-TF scan results, but six had positive Pgp expression and four had negative Pgp expression. Significant differences in the incidences of good and poor responses were found between patients with positive Tc-TF scan results and patients with negative Tc-TF scan results and between patients with positive Pgp expression and patients with negative Pgp expression. No significant differences in the incidences of good and poor responses were found between Hodgkin's disease patients and non-Hodgkin's lymphoma patients, stage I–II patients and III–IV patients, patients aged >40 and patients aged ≤40 years, and patients with and without B symptoms. Compared with other prognostic factors, Tc-TF scan results and Pgp expression more accurately predict the chemotherapy response in patients with ML.     

Usefulness of technetium-99m tetrofosmin scintimammography to detect breast cancer in mammographically dense breasts

The purpose of this study was to assess the usefulness of techentium-99m tetrofosmin (Tc-TF) scintimammography to detect breast cancer in 32 female Taiwanese patients with indeterminate mammograpic probability of malignancy because of mammographyically dense breasts. All breast masses were removed and final histopathological diagnoses were obtained in all cases. The results showed that Tc-TF scintimammography findings were true-positive in 20 cases, false-positive in 1 case, true-negative in seven cases, and false-negative in four cases. The diagnostic sensitivity, specificity, and accuracy were 83, 88, and 84%, respectively, for detecting breast cancer in mammographically dense breasts. In conclusion, Tc-TF scintimammography is a useful tool for detecting breast cancer in patients with indeterminate mammograms because of mammographically dense breasts.     

Detecting breast cancer in mammographically dense breasts: comparing technetium-99m tetrofosmin mammoscintigraphy and ultrasonography

The aim of our study was to compare the usefulness of technetium-99m tetrofosmin (Tc-TF) mammoscintigraphy and ultrasonography for detecting breast cancer in mammographically dense breasts. This study included 32 female Taiwanese patients with indeterminate mammographic probability of malignancy due to mammographically dense breasts. Both Tc-TF mammoscintigraphy and ultrasonography were performed on each patient. Then, all of the 32 breast masses underwent biopsies or operations to obtain final pathological diagnoses. Based on the final pathological diagnoses, 24 women had breast cancer and eight had benign breast tumors among the 32 patients. Twenty cancers and one benign tumor had positive Tc-TF mammoscintigraphic findings. The sensitivity, specificity, and accuracy were 83, 88, and 84%, respectively. Twenty-two cancers and five benign tumors had positive ultrasonographic findings. The sensitivity, specificity, and accuracy were 92, 38, and 78%, respectively. To detect breast cancer in patients with nondiagnostic mammograms because of mammographically dense breasts, ultrasonography with its higher sensitivity is more suitable for screening breast masses. However, due to its higher specificity, Tc-TF mammoscintigraphy is useful to confirm the ultrasonographic findings.     

P-Glycoprotein and multidrug resistance-related protein expressions in relation to technetium-99m methoxyisobutylisonitrile scintimammography findings

The purpose of this study was to retrospectively study 48 patients with infiltrating ductal breast cancer to evaluate the relationship between the degree of accumulation of technetium-99m methoxyisobutylisonitrile (Tc-MIBI) and P-glycoprotein (Pgp) or multidrug resistance-related protein (MRP) expression in breast cancer tissues. Before surgery or biopsy, all 48 patients underwent scintimammography started 10 min after the injection of Tc-MIBI. Tumor:background (T:B) ratios were calculated from the Tc-MIBI scintimammography. Immunohistochemical analysis was performed on the pathological specimens of the 48 breast tumors to determine Pgp and MRP expression. According to the results of immunohistochemical analysis, the 48 breast cancers were separated into four groups: (a) group 1, 12 cancers with both positive Pgp expression and positive MRP expression; (b) group 2, 12 cancers with positive Pgp expression and negative MRP expression; (c) group 3, 12 cancers with negative Pgp expression and positive MRP expression; and (d) group 4, 12 cancers with both negative Pgp expression and negative MRP expression. Among the four groups, the T:B ratio was lowest in group 1 (1.13+/-0.10) and highest in group 4 (2.17+/-0.14), respectively (P < 0.05). The T:B ratios of groups 2 (1.30+/-0.25) and 3 (1.32+/-0.26) were between those of groups 1 and 4. Our data confirmed that Tc-MIBI scintimammography is useful for determining Pgp and MRP expression in patients with breast cancers.     

结直肠锯齿状腺瘤、传统腺瘤及结直肠癌中端粒酶、p53及Ki-67的表达比较

背景与目的：结直肠锯齿状腺瘤(serrated adenoma,SA)是2000年被WHO正式命名为独立的一种疾病,与传统腺瘤(traditional adenoma,TA)和结直肠癌(colorectal carcinoma,CRC)比较有其独特的性质。本研究通过对锯齿状腺瘤、传统腺瘤和结直肠癌组织中端粒酶、p53及Ki-67的免疫组化表达比较,探讨锯齿状腺瘤与普通腺瘤的恶性潜能异同及与大肠腺癌的关系。方法：运用免疫组化MaxVision法对37例锯齿状腺瘤、36例传统腺瘤,34例结直肠癌组织标本进行端粒酶、p53及Ki-67检测。结果：端粒酶在锯齿状腺瘤、传统腺瘤和结直肠癌组间差异有统计学意义(P<0.05),结直肠癌组阳性率高于锯齿状腺瘤组(P<0.05),锯齿状腺瘤组高于传统腺瘤组(P<0.01);Ki-67在锯齿状腺瘤与传统腺瘤两组差异无统计学意义(P>0.05),结直肠癌组的阳性率则明显高于锯齿状腺瘤和传统腺瘤组(P<0.01);结直肠癌组p53阳性率高于传统腺瘤组(P<0.01),传统腺瘤组高于锯齿状腺瘤组(P<0.01)。结论：端粒酶、p53及Ki-67检测显示：锯齿状腺瘤是一种具有较强活性的腺瘤,端粒酶的激活可能在其癌变过程中起一定作用。     

Ki-67, Bcl-2 and p53 expression in primary and metastatic melanoma

The aim of this study was to clarify the roles of the tumour proliferation marker Ki-67, the anti-apoptotic protein Bcl-2 and the cell cycle regulator p53 in primary cutaneous and metastatic melanoma. One hundred and seventeen primary melanomas and 18 metastatic tissue samples were analysed for immunohistochemical expression of Ki-67, Bcl-2 and p53. The staining results were correlated with disease progression and clinical outcome. The patient population comprised patients diagnosed with melanoma between 1988 and 1991. The clinical follow-up period for disease recurrence was 4.6 years (median; range, 0.2-7.5 years) and the follow-up period for overall survival was 10.0 years (median; range, 8.6-15.6 years). Ki-67 expression was not a prognostic factor in primary melanoma. High Bcl-2 expression was associated with such adverse prognostic factors as male gender, old age of the patient and tumour ulceration. High Bcl-2 expression was also associated with an adverse prognosis in intermediate-thickness (1.01-4.0 mm) melanomas (n=52) for disease-free (P=0.09) and overall (P=0.08) survival. In multivariate analysis, tumour thickness was the strongest prognostic factor for disease-free survival (P<0.01). High p53 expression indicated a poorer prognosis (P=0.05). In metastatic melanoma, the expression levels of Bcl-2 and p53 were lower than those in their primary counterparts (P=0.08 for each). Ki-67 expression showed no remarkable changes. It can be concluded that high p53 expression in tumour cells is associated with a poorer prognosis in primary melanoma, and high Bcl-2 expression in tumour cells is an adverse prognostic marker in intermediate-thickness primary melanoma.     

Preoperative localization of parathyroid adenomas with technetium-99m methoxyisobutylisonitrile imaging: relationship with P-glycoprotein expression, oxyphilic cell content, and tumoral tissue volume

In addition to tumor size, it has been suggested that P-glycoprotein (P-gp) expression and/or oxyphilic cell content in parathyroid adenomas has an important influence on the results of technetium 99m methoxyisobutylisonitrile (Tc-99m MIBI) parathyroid imaging. AIM: In this study, we compared the results of MIBI parathyroid imaging and immunohistochemical analysis (IHA) of P-gp expression, oxyphilic cell content, and tumoral tissue volume in parathyroid adenomas. We also evaluated the relationship between MIBI and ultrasound (US) results, operation findings, serum biochemical values. MATERIALS AND METHODS: Forty (40) patients (36 female and 4 male; mean age, 53.2 +/- 8.16 years) with hyperparathyroidism who had undergone surgery were included in this study. Preoperatively, "double phase" parathyroid scintigraphy with Tc-99m MIBI (including imaging of the neck and mediastinum) was performed in all patients. Thirty-two (32) of the patients had also neck US. Serum parathormon (PTH), calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP) levels were measured preoperatively. In resected parathyroid tissues, P-gp expression and percentage of oxyphilic cell content were analyzed with IHA in 34 patients. RESULTS: Three (3) of the resected parathyroid tissues were hyperplastic parathyroid tissue, whereas 31 of the tissues were parathyroid adenoma (mean volume, 1.99 +/- 1.93 mL). In Tc-99m MIBI parathyroid scintigraphy, 70% of the parathyroid adenoma/hyperplastic parathyroid tissue was detected in correct localization; at US, this rate was 46.8%. According to the resected parathyroid tissue localization at surgery, sensitivity, accuracy, positive predictive value, and prevalence in scintigraphy were 82.3%, 70%, 82.3%, and 85%, respectively. Those were 60%, 46.8%, 68.2%, and 78.1% for US, respectively. No significant correlation and no concordance was found between MIBI and US results (kappa, -0.103, r = -0.11; p: 0.53). Interestingly, significant correlation was found between tumoral volume and ALP level (r = 0.42; p = 0.010) and between PTH and ALP levels (r = 0.72; p < 0.001). Significant correlation was also found between patient age and tumoral volume (r =-0.37; p = 0.02) and between PTH and serum Ca levels (r = 0.32; p = 0.04). In 23 of 34 patients in whom histopathological examination was done MIBI was positive and in 13 of these patients (56.5%), P-gp expression was positive. When the histopathological results and MIBI results were compared, there was no significant correlation and concordance between P-gp expression (kappa = 0.09, r = 0.10; p = 0.54), oxyphilic cell content (r = -0.17; p = 0.33), and tumoral tissue volume (r = -0.14; p = 0.38). In 12 of 19 patients (63%) who had parathyroid tissue < 1 mL and in 15 of 24 patients (62.5%) who had oxyphilic cell content < 10%, lesions were also detected correctly with MIBI scintigraphy. CONCLUSIONS: Present study results suggest that MIBI scintigraphy was clearly superior to US as a diagnostic tool. However, P-gp expression, oxyphilic cell content, and tumoral volume may have not a main effect on MIBI parathyroid scintigraphy results in parathyroid adenoma.     

Detection of recurrent nasopharyngeal carcinomas after radiotherapy with technetium-99m tetrofosmin single photon emission computed tomography in patients with indeterminate magnetic resonance imaging findings

The aim of this study is to evaluate the effectiveness of technetium-99m tetrofosmin (Tc-99m TF) single photon emission computed tomography (SPECT) of head and neck for detecting suspected recurrence of nasopharyngeal carcinomas (NPCs) when magnetic resonance imaging (MRI) findings are indeterminate. MRI was performed 4 months after radiotherapy and 26 NPC patients with indeterminate MRI findings were included. MRI, Tc-99m TF SPECT, and biopsy were performed within 1 week. The final results were based on histopathologic findings and clinical follow-up for at least 6 months. For detecting recurrent NPC in indeterminate MRI findings, the sensitivity, specificity, and accuracy of Tc-99m TF SPECT were 92.3%, 100.0%, and 96.2%, respectively. Based on this result, we can suggest Tc-99m TF SPECT is effective to detect recurrent NPC when MRI findings are indeterminate. However, further studies including a larger NPC patient population are warranted to determine the exact role and clinical usefulness of Tc-99m TF SPECT to differentiate benign lesions and recurrent NPC when MRI findings are indeterminate.     

Comparison of (99m)Tc-sestamibi and doxorubicin to monitor inhibition of P-glycoprotein function

P-glycoprotein (Pgp) overexpression is a well-recognized factor in resistance to chemotherapy. Doxorubicin flow cytometry is used to monitor Pgp function in haematological specimens and biopsies from other cancers, and radionuclide imaging with sestamibi has recently shown promise for non-invasive monitoring. In the present study the two methods were directly compared in single-cell suspensions of three variants of the human breast carcinoma cell line MCF7: sensitive MCF7/WT, doxorubicin-selected MCF7/AdrR, and MDR1-gene-transfected MCF7/BC19 cells with doxorubicin resistance factors of 1, 192, and 14, respectively. Accumulation of sestamibi and mean fluorescence of doxorubicin (5.5 microM) were assessed over 60 min in the presence and absence of Pgp modulators GG918 (0.01 to 0.2 microM) and PSC833 (0.05 to 2.0 microM). Accumulation curves for sestamibi and doxorubicin differed among the cell variants under control conditions, with sestamibi showing a significantly greater difference between WT and resistant cells than doxorubicin. Both GG918 and PSC833 reversed uptake deficits to WT levels for sestamibi in MCF7/BC19 cells and doxorubicin in MCF7/BC19 and MCF7/AdrR cells, but failed to show the same effect for sestamibi in MCF7/AdrR cells (approximately 30% of MCF7/WT level). Thus, both methods clearly distinguished sensitive from resistant MCF7 variants, with the radionuclide method showing greater sensitivity.     

Preparation and properties of antitumor monoclonal antibodies labeled with metallic radionuclides indium-111, gallium-67, and technetium-99m

In this study, metallic radionuclides such as 111In, 67Ga, or 99mTc produced clear visualization in scintigraphic imaging of tumors; they have short half-lives and can easily be used in the radiolabeling of monoclonal antibodies by using bifunctional chelating agents. Under selected conditions, these radiolabeled antibodies were stable both in vitro and in vivo with no loss of the antigen-binding activity. Despite high background imaging of the liver and kidney, transplanted tumors in nude mice were clearly visualized with 111In-, 67Ga-, and 99mTc-labeled antibodies at 6, 24, or 48 hours after the injection. Although tissue distribution in the liver, kidney, and bone was different among radionuclides used for the labeling, all tumor to blood ratios were higher than those of radioiodinated monoclonal antibodies. These results provide a good basis for studies of the clinical usefulness of 111In-, 67Ga-, and 99mTc-labeled monoclonal antibodies for radioimmunoimaging.     

Ki-67、p53及HER-2在结直肠癌组织中表达的临床意义

目的:了解Ki-67、p53及HER-2在结直癌组织中表达的临床意义.方法:采用免疫组化法,观察Ki-67、p53、HER-2在39例结直肠癌组织中的表达特点,并与Dukes分期、组织分化等临床病理特征进行研究探讨.结果:Ki-67、p53及HER-2在结直肠癌组织中的阳性表达率分别为82.1％、56.4％及10.3％;在结直肠癌中,Ki-67在年龄大小和有无淋巴结转移表达中有显著差异(P＜0.05);p53和HER-2在患者性别、年龄、部位、分化程度、Dukes分期、淋巴结转移表达无明显差异(P＞0.05);结直肠腺癌组织中Ki-67与p53的表达呈正相关.结论:联合检测Ki-67和p53在结直肠腺癌中的表达有利于对结直肠腺癌恶性程度及患者预后进评估;而HER-2基因在结直肠肿瘤的表达及相关性治疗,仍需要进一步研究、探讨及验证.     

Determination and prediction of P-glycoprotein and multidrug-resistance-related protein expression in breast cancer with double-phase technetium-99m sestamibi scintimammography. Visual and quantitative analyses

PURPOSE: To determine and predict P-glycoprotein (Pgp) and multidrug-resistance-related protein (MRP) expression in untreated breast cancer patients by visual and quantitative indices of double-phase (99m)Tc MIBI scintimammography (DSMM). PATIENTS AND METHODS: Eighty-two patients with untreated breast cancer received DSMM. Pgp and MRP expression was assessed by immunohistochemical (IHC) staining of surgical specimens. Visual and quantitative analyses were compared with the results of IHC to determine and predict Pgp and MRP. RESULTS: The early and delayed tumor to normal tissue ratio (T/N) of the Pgp-negative and MRP-negative group had significantly higher values than those of the Pgp-positive and MRP-positive group. However, there were no statistically significant differences in washout rate (WR, in %) according to the expression of Pgp and MRP. The optimal T/N ratios were 相似文献   

少突胶质细胞瘤临床病理特征及与GFAP、VIM、p53、Ki-67表达的相关性

目的:探讨少突胶质细胞瘤的临床病理分级及与GFAP、VIM、p53、Ki-67表达的相关性。方法:对170例术后病理诊断为少突胶质细胞瘤患者的肿瘤免疫组织化学病理进行回顾性分析,研究少突胶质细胞瘤GFAP、VIM、p53、Ki-67与临床病理特征之间的关系及它们之间的相关性。所有数据采用Excel软件录入,SPSS 17.0统计软件进行数据处理,卡方检验,P＜0.05认为差异具有统计学意义。结果:根据2007年WHO中枢神经系统分类标准:少突型53例,间变少突型43例,星形-少突型55例,间变星形-少突型19例。不同病理分级少突胶质细胞瘤GFAP（P=0.035）、p53（P=0.004）、Ki-67（P=0.000）的表达不同,可能与病理分级相关。VIM（P=0.967）与不同病理分级无关。结论:少突胶质细胞瘤的不同病理分型与p53、GFAP、Ki-67的阳性表达有关,GFAP阳性表达随着肿瘤级别的增加而减少;相反地,p53、Ki-67的阳性表达随着肿瘤级别的增加而增加。     

Using technetium-99m-tetrofosmin scan to predict chemotherapy response of malignant lymphomas, compared with P-glycoprotein and multidrug resistance related protein expression

The ability of technetium-99m tetrofosmin (Tc-TF) scan to predict chemotherapy response in malignant lymphomas (ML) was compared with the predictive ability of P-glycoprotein (Pgp) and multidrug resistance related protein (MRP) expression. Before chemotherapy, 25 ML patients were enrolled in this study. Scans were performed 10 min after intravenous injection of Tc-TF. Immunohistochemical analyses were performed on ML specimen sections to evaluate Pgp and MRP expression. Chemotherapy response was evaluated in the first 1-2 years after completion of chemotherapy. Based on Tc-TF scan results, the mean tumor-to-background (T/B) ratio of the 15 patients with good response (3.23 +/- 0.56) was significantly higher than that of the 10 patients with poor response (1.18 +/- 0.11). All 15 patients with good response had positive Tc-TF scan results but negative Pgp and MRP expression. All 10 patients with poor response had negative Tc-TF scan results but positive Pgp or MRP expression. No significant differences in the incidences of good and poor response results were found for patients with Hodgkin's disease versus non-Hodgkin's lymphoma, with stage I-II versus stage III-IV, with age > 40 versus age < or = 40 years, or with B symptoms versus without B symptoms. Tc-TF scan results, which may represent either Pgp or MRP expression, accurately predict chemotherapy response in patients with ML.     

Expression of Ki-67, p53 and VEGF in Pediatric Neuroblastoma

Background: Neuroblastoma (NB), is a neuroectodermal tumor derived from neural crest cells, and it is thesecond most common pediatric malignant tumor. The biological and clinical behavior of NB is very heterogeneous.This study was conducted to evaluate the expression of Ki-67, p53 and VEGF markers in tissues obtained fromNB patients with different histologic types and stage. Materials and Methods: Tissue microarray (TMA) blockswere constructed from paraffin blocks of the NB tissues. Immunohistochemical staining was performed on TMAsections to detect the expression of Ki-67, p53 and VEGF markers. The association between the expression ofthese markers and clinicopathological parameters were then analyzed. Results: We had 18 patients with NB,one patient with ganglioneuroblastoma (GNB) and one with ganglioneuroma. Ki-67 was expressed in 13 (65%)tumors, and negatively correlated with age, prognosis, histologic type and stage of NB (all p<0.05). High andmoderate expression of VEGF was found in 5% (1/20) and 65% (13/20) of the tumors, respectively; and it waspositively correlated with age, prognosis and histologic types (all p<0.05) and negatively correlated with MKI(mitosis-karyorrhexis index). p53 expression was observed in 10% (2/20) of the tumors, which showed a relativecorrelation with MKI (p value=0.07). Conclusions: VEGF as a candidate for anti-angiogenic targeted therapywas correlated with the development and progression of NB; therefore, VEGF along with Ki-67 can serve as avaluable marker for the prognosis of this tumor type.     

Analysis of Ki-67, p53 and Bcl-2 expression in the dysplasia-carcinoma sequence of Barrett's esophagus.

The grading of dysplasia in Barrett's esophagus has prognostic importance, however observer variation limits the reliability of simple histological analysis alone. We investigated Ki-67, p53 and Bcl-2 expression in Barrett's esophagus, in the sequence from Barrett's low-grade dysplasia to high-grade dysplasia and infiltrating adenocarcinoma. Forty-four esophagectomy specimens were utilized: 39 specimens with esophageal dysplasia and adenocarcinoma and 5 specimens with esophageal dysplasia only. This gave 83 sections (2 sections for specimens with dyplasia and carcinoma) examined from 44 patients. The sections were examined for Ki-67, p53 and Bcl-2 reactivity by immunohistochemistry. Low-grade dysplasia was present in 14 sections, high-grade dysplasia in 30 sections and carcinoma in 39 sections. Ki-67 expression occurred in 2 out of 14 (14%) sections with low-grade dysplasia, in 22 out of 30 (73%) sections with high-grade dysplasia and in 34 out of 39 (87%) sections with carcinoma (p<0.001). p53 protein expression was found in 1 of 14 (7%) sections with low-grade dysplasia, in 18 of 30 (60%) sections with high-grade dysplasia and in 33 of 39 (85%) sections with carcinoma (p<0.001). Expression of Bcl-2 was found in 11 of 14 (84%) sections with low-grade dysplasia but immunoreactivity was not seen in any section with high-grade dysplasia or Barrett's carcinoma. Our results indicate that overexpression of Ki-67, Bcl-2 protein and p53 mutations can be identified as early events during neoplastic progression in Barrett's esophagus. These data support the hypothesis that, in the progression of Barrett's metaplasia to adenocarcinoma, the balance of proliferation/apoptosis plays an important role.     

VEGF、Ki-67和P53在非小细胞肺癌组织中的表达及意义

目的 检测VEGF、Ki-67和P53在非小细胞肺癌(NSCLC)组织中的表达情况及临床意义。方法 采用免疫组化方法检测78例NSCLC组织中VEGF、Ki-67和P53的表达情况,并结合肺癌的临床病理特征进行分析。结果 VEGF在NSCLC中的阳性表达率为67%(52/78),Ki-67在NSCLC中的阳性表达率为71%(55/78),P53在NSCLC中的阳性表达率为50%(39/78),它们的表达情况均与肿瘤组织的分化程度及临床分期有关(P＜0.05),与肺癌的组织学分型、有无淋巴结转移及年龄无关(P＞0.05),肿瘤组织分化越差、临床分期越晚者三者表达的阳性率越高。VEGF、Ki-67和P53表达阳性者总生存时间明显差于阴性表达者(P＜0.05)。结论 VEGF、Ki-67和P53与肺癌的发生、发展有关,对于判断非小细胞肺癌的预后及指导治疗有重要的参考意义。     

To predict chemotherapy response using technetium-99m tetrofosmin and compare with p-glycoprotein and multidrug resistance related protein-1 expression in patients with untreated small cell lung cancer.

The aim of this study was to investigate the relationships among technetium-99m tetrofosmin (Tc-TF) accumulation in untreated small cell lung cancer (SCLC), the expression of P-glycoprotein (Pgp) and multidrug resistance related protein-1 (MRP1), and the response to chemotherapy in patients with untreated SCLC. Thirty patients with SCLC were studied with chest scintigraphy 15 to 30 min after intravenous injection of Tc-TF before chemotherapeutic induction. Tc-TF chest scans were interpreted both visually and quantitatively. The response to chemotherapy was evaluated upon completion of chemotherapy. Immunohistochemical analyses were performed on multiple non-consecutive sections of biopsy specimens to detect Pgp and MRP1 expression. Fifteen patients with good response to chemotherapy had a significantly higher incidence (100.0%) of positive Tc-TF chest single photon emission computed tomography (SPECT) findings and negative Pgp or MPR expression than 15 patients with poor response (20%) (P<0.05). The tumor/background (T/B) ratios were 1.8+/-0.3 and 1.2+/-0.3 for patients with good response and poor response, respectively (P<0.05). However, other prognostic factors (performance status, tumor size and stage) were not significantly related to Tc-TF chest scan findings and response to chemotherapy. Tc-TF chest scintigraphy correlated well with Pgp or MRP1 expression and accurately predicted the response to chemotherapy in patients with SCLC.