18F-FLT细胞摄取率评价结直肠癌HCT116细胞早期放射反应

目的 观察不同剂量6MVX射线照射人结直肠癌细胞株HCT116后,体外细胞摄取18F-FLT的变化,分析18F-FLT用于早期预测肿瘤放射反应性的可行性.方法 测定1.0×105 ～1.5×106个细胞、培养36、60、84 h条件下,结直肠癌细胞株HCT116的18F-FLT摄取率.测定细胞经0、2、4、6、8 Gy6 MVX射线照射后,不同时间点(24、48、72 h)18F-FLT的细胞摄取率及细胞摄取抑制率;同时测定不同剂量照射后的细胞生长曲线、细胞增殖及细胞周期情况.结果 HCT116细胞对18F-FLT摄取率达(18.97 ±1.16)％.18F-FLT细胞摄取抑制率在照射2、4、6、8 Gy后24 h分别为(32.10±0.02)％、(54.46±0.04)％、(62.74±0.04)％和(65.81±4.81)％;18F-FLT细胞摄取抑制率与照射剂量呈正相关. 18F-FLT细胞摄取率与细胞周期S期比例呈正相关.结论 18F-FLT细胞摄取率可以早期反映人结直肠癌HCT116细胞株对放射的反应性.     

结直肠癌合并肝脏转移的介入治疗

目的 探讨结直肠癌合并肝脏转移经导管动脉灌注及栓塞治疗的价值. 资料与方法 35例结直肠癌合并肝脏转移患者,行结直肠肿瘤供血动脉插管灌注化疗和/或栓塞术,同时对肝脏转移瘤行动脉插管灌注化疗栓塞术.其中介入治疗后1～3个月23例患者行结直肠肿瘤外科手术切除,6例肝脏单发转移癌行外科手术切除.结果 所有病例术后1～3个月随访复查CT,结直肠肿块显效11例,有效22例,无效2例;肝脏转移灶显效20例,有效12例,无效3例.23例外科手术切除肿瘤顺利,术中出血300～1500 ml,术后病理提示肿瘤坏死明显,可见纤维组织增生和炎性细胞浸润.6例肝脏转移瘤外科切除,术后病理提示1例未见癌细胞,其余5例可见少量癌细胞,坏死明显.结论 经导管动脉灌注及栓塞治疗结直肠癌合并肝脏转移疗效显著,值得推广.     

CD44在结直肠癌病灶及转移淋巴结中的表达及临床意义

目的探讨CD44在结直肠癌中的表达及临床意义。方法采用免疫组化方法,检测65例结直肠癌原发灶、正常结肠黏膜、转移淋巴结CD44表达。采用寿命表法分析CD44表达对患者生存的影响。结果 65例结直肠癌原发灶、正常结肠黏膜、转移淋巴结CD44表达阳性率分别为:47.7%、21.5%、89.2%。癌原发灶和转移淋巴结中CD44表达阳性率高于正常肠黏膜组织(P<0.01)。按结直肠癌TNM分期,Ⅱ、Ⅲ期CD44阳性率高于Ⅰ期(P<0.01),Ⅲ期阳性率高于Ⅱ期(P<0.05)。比较不同病理组织学类型CD44表达检测结果,低分化腺癌CD44阳性率高于中分化和高分化腺癌(P<0.05)。结直肠癌原发灶CD44阳性组淋巴结转移率为74.2%。CD44阴性组淋巴结转移率为41.2%。两组比较有显著统计学差异(P<0.01)。采用寿命表法分析CD44表达对患者生存率的影响,3年无病累积生存率CD44阳性组为52.4%,CD44阴性组为77.5%,两组比较有统计学差异(P<0.05)。结论 CD44表达与结直肠癌发生、淋巴结转移及患者预后密切相关。     

circAPLP2对结直肠癌细胞SW480侵袭与转移的影响及其机制

目的 探讨circAPLP2对结直肠癌细胞SW480侵袭与转移的调控作用及其分子机制。方法 采用在线数据库Starbase预测circAPLP2与miR-497-5p的结合位点,TargetScan预测miR-497-5p与FGFR1的结合位点。采用qRT-PCR检测LoVo、DLD1、SW480、SW620、Caco-2、HCoEpiC细胞中circAPLP2、miR-497-5p的相对表达水平,Westernblotting检测FGFR1蛋白的相对表达水平。取SW480细胞,设置：(1)siNC组(转染siControl)与sicircAPLP2组(转染sicircAPLP2),采用qRT-PCR检测circAPLP2、miR-497-5p、FGFR1 mRNA的相对表达水平,Western blotting检测FGFR1蛋白的表达;(2)Vector组(转染对照空载质粒)与circAPLP2组(转染circAPLP2过表达质粒),采用qRT-PCR检测miR-497-5p、FGFR1mRNA的相对表达水平,Westernblotting检测FGFR1蛋白的相对表达水平;(3)si...     

18F-FDG PET在结直肠癌中的临床应用价值

18F-FDG PET在结直肠癌原发、复发及转移的诊断中具有重要价值,特别是在结直肠癌的分期治疗方案的选择方面.结合CT、MRI和CEA(癌胚抗原)检测可以提高诊断的准确性.同时,18F-FDG PET在对结直肠癌的疗效监测以及评价手术效果方面也有比较重要的作用.     

立体定向放射治疗在结直肠癌肝肺寡转移中的应用进展

结直肠癌是全球范围内最常见的恶性肿瘤之一,远处转移是导致结直肠癌患者死亡的主要原因。不同于广泛性转移,寡转移是肿瘤转移过程中的一种中间状态,积极治疗预后较好。随着放疗技术的进步,立体定向放射治疗在肿瘤局部治疗中发挥着越来越大的作用。本文就结直肠癌肝肺寡转移立体定向放射治疗现状进行综述。     

18F-FDG符合线路显像在结直肠癌术后随访中的应用

本研究对43例结直肠癌术后怀疑复发或转移的患者行^18F-脱氧葡萄糖（FDG）双探头符合线路显像，并对比同期CT或B超检查，以评价^18F-FDG显像在结直肠癌术后随访中的价值，现报道如下。     

肺结节对结直肠癌病人的意义

摘要目的结/直肠癌病人X线摄影发现小的肺结节时比较麻烦,因为这些肺结节的发现增加了肿瘤发生转移的可能。本研究试图确定结/直肠癌病人初期发现肺结节后合适的影像学随访时间。方法回顾分析376例结/直肠癌病人行手术治疗后,初期和随访胸部X线平片和CT检查的记录。结果本次研究共纳入92例病人的胸部X线平片和胸部CT,所有病人在初次检查时发现了至少一个肺结节,且未见合并其他肿瘤。     

^18F—FDG PET在结直肠癌中的临床应用价值

^18F—FDG PET在结直肠癌原发、复发及转移的诊断中具有重要价值，特别是在结直肠癌的分期治疗方案的选择方面。结合CT、MRI和CEA(癌胚抗原)检测可以提高诊断的准确性。同时，^18F—FDG PET在对结直肠癌的疗效监测以及评价手术效果方面也有比较重要的作用。     

Mechanisms underlying 18F-fluorodeoxyglucose accumulation in colorectal cancer

Positron emission tomography (PET) with ¹⁸F-fluorodeoxyglucose (FDG) is a diagnostic tool to evaluate metabolic activity by measuring accumulation of FDG, an analogue of glucose, and has been widely used for detecting small tumors, monitoring treatment response and predicting patients’ prognosis in a variety of cancers. However, the molecular mechanism of FDG accumulation into tumors remains to be investigated. It is well-known that most cancers are metabolically active with elevated glucose metabolism, a phenomenon known as the Warburg effect. The underlying mechanisms for elevated glucose metabolism in cancer tissues are complex. Recent reports have indicated the potential of FDG-PET/CT scans in predicting mutational status (e.g., KRAS gene mutation) of colorectal cancer (CRC), which suggests that FDG-PET/CT scans may play a key role in determining therapeutic strategies by non-invasively predicting treatment response to anti-epidermal growth factor receptor (EGFR) therapy. In this review, we summarize the current findings investigating the molecular mechanism of ¹⁸F-FDG accumulation in CRC.     

~(18)F-FDGPET/CT显像在结直肠癌诊断中的应用价值

18F-FDGPET/CT是一种将CT解剖结构成像与PET功能代谢显像融合于一身的显像技术,能够在活体状态下对肿瘤组织进行定性和定位分析,在肿瘤显像领域发挥着重要作用,并且临床应用日益广泛。就18FFDG PET/CT显像原理,在结直肠癌术前诊断和术后复发中的应用(包括术后局部复发和术后远处转移的诊断),以及血清肿瘤标志物升高时18F-FDG PET/CT显像的诊断价值等予以综述。     

结直肠癌肝转移机制研究新进展

近年来我国结直肠癌发病率呈上升趋势,肝脏转移是影响结直肠癌患者预后和长期生存的主要原因。结直肠癌肝脏转移是多因素参与、多步骤的复杂生物学过程,其作用机制目前仍不清楚。作者旨在对结直肠癌肝脏转移的机制及新进展作一综述。     

Fluorine-18 fluorodeoxyglucose PET in the preoperative staging of colorectal cancer

Introduction In patients with colorectal cancer (CC), preoperative evaluation and staging should focus on techniques that might alter the preoperative or intraoperative surgical plan. Conventional imaging methods (CT, MRI) have low accuracy for identifying the depth of tumour infiltration and have limited ability to detect regional lymph node involvement. The aim of this study was to evaluate the utility of FDG-PET in the initial staging of patients with CC in comparison with conventional staging methods and to determine its impact on therapeutic management. Methods One hundred and four patients with a diagnosis of CC (53 males and 51 females; mean age 66.76 ± 12.36 years), selected prospectively, were studied for staging using a standard procedure (CT) and FDG-PET. When possible, the reference method was histology. Results In 14 patients, surgery was contraindicated by FDG-PET owing to the extent of disease (only 6/14 suspected by CT). FDG-PET revealed four synchronous tumours. For N staging, both procedures showed a relatively high specificity but a low diagnostic accuracy (PET 56%, CT 60%) and sensitivity (PET 21%, CT 25%). For M assessment, diagnostic accuracy was 92% for FDG-PET and 87% for CT. FDG-PET results led to modification of the therapy approach in 50% of patients with unresectable disease. FDG-PET findings were important, revealing unknown disease in 19.2%, changing the staging in 13.46% and modifying the scope of surgery in 11.54% (with a change in the therapeutic approach in 17.85% of those patients with rectal cancer). Conclusion Compared with conventional techniques, FDG-PET appears to be useful in pre-surgical staging of CC, revealing unsuspected disease and impacting on the treatment approach.     

PET-CT显像在结肠直肠癌术后复查的临床应用

目的:评价18F-脱氧葡萄糖(FDG)PET-CT显像与CT扫描在诊断结肠直肠癌术后转移与否的准确性。方法:20例临床可疑(血清癌胚抗原(CEA)升高或CT显像阳性或可疑)结肠直肠癌术后转移的患者行全身18F-FDG PET-CT显像,PET-CT显像结果与CT扫描结果对比分析。结果:20例患者共有病灶27个,病理组织学结果及临床随访结果证实,20个恶性病灶,7个良性病灶。PET-CT显像的阳性预测值为94.7%,阴性预测值为75%,CT扫描结果的阳性预测值为81.3%,阴性预测值为36.3%,两者有显著性差异。结论:全身18F-FDG PET-CT显像在诊断结肠直肠癌术后转移与否的准确性高于比CT扫描结果。     

Intra-arterial chrono-chemotherapy for liver metastasis arised from colorectal cancer

Introduction Colorectal cancer has a tendency to involve the liver. Unfortunately, for the patients with liver metastasis surgical resection rate is very low, and so chemotherapy becomes a primary treatment method. Some authors have reported that systemic chemothe- rapy via the chrono-modulated infusion can decrease the toxic effects of the anticancer drugs because of the effect of circadian rhythms[1], and if chemotherapy via the arterial infusion, the local concentration of the drugs in tumo…     

大肠癌肝转移的射频消融治疗

目的研究大肠癌肝转移射频消融(RFA)治疗近期局部疗效和不良反应。方法大肠癌肝转移患者32例,病灶总数71个,其中直径小于4.0 cm的病灶41个,4.1~5.0 cm者14个,5.1~6.0 cm者9个,大于6.1 cm者7个。经RFA治疗1个月后行螺旋CT双期增强扫描评价肿瘤治疗效果。结果不同大小瘤灶经消融治疗后达到完全坏死者分别为41个(41/41),13个(13/14),4个(4/9),2个(2/7)。无严重不良反应和并发症。结论RFA安全可靠,不良反应小,是治疗大肠癌肝转移的有效方法之一。     

Comparison of methodologies for the in vivo assessment of <Superscript>18</Superscript>FLT utilisation in colorectal cancer

Fluorine-18 3-deoxy-3-fluorothymidine (¹⁸FLT) is a tissue proliferation marker which has been suggested as a new tumour-specific imaging tracer in positron emission tomography (PET). The objectives of this study were to investigate the pharmacokinetics of ¹⁸FLT in patients with colorectal cancer, defining methodologies for the quantitative analysis of the in vivo ¹⁸FLT uptake and subsequently assessing the accuracy of semi-quantitative measures. Dynamic acquisitions over a single field of view of interest identified by computed tomography were carried out for up to 60 min following injection of ¹⁸FLT (360±25 MBq). Dynamic arterial blood sampling was carried out in order to provide a blood input function. Simultaneous venous samples were also taken in order to investigate their potential utilisation in deriving a hybrid input function. Arterial and venous blood samples at 5, 15, 30, 60 and 90 min p.i. were used for metabolite analysis. Eleven patients with primary and/or metastatic colorectal cancer were studied on a lesion by lesion basis (n=21). All acquired images were reconstructed using ordered subsets expectation maximisation and segmented attenuation correction. Time-activity curves were derived by image region of interest (ROI) analysis and image-based input functions were obtained using abdominal or thoracic aorta ROIs. Standardised uptake values (SUVs) were calculated to provide semi-quantitative indices of uptake, while non-linear regression (NLR) methodology in association with a three-compartment model and Patlak analysis were carried out to derive the net influx constant K _i . The metabolite analysis revealed two radioactive metabolites, with the parent compound representing ~80% of the total radioactivity in the 30-min plasma sample. In the case of NLR, better fits were obtained with a 3k model (i.e. k ₄=0) for both lesion and bone marrow time-activity curves. For the same lesions, a high correlation was observed between the K _i derived from either Patlak analysis or NLR(3k) and the corresponding SUVs. Our results also suggest that the quantitative behaviour of ¹⁸FLT in vivo (up to 60 min p.i.) may be characterised using a 3k model or Patlak analysis in combination with image-derived input functions. The good correlation found between the SUVs (at 60 min) and K _i values supports the use of semi-quantitative indices to assess the proliferation rate of colorectal cancer lesions in vivo with ¹⁸FLT.The work included in this paper was selected for consideration in the Marie-Curie award during the European Association of Nuclear Medicine 2002 meeting in Vienna.     

DDX46基因对结肠癌细胞电离辐射敏感性的影响及机制研究

目的 探讨DDX46基因对结肠癌细胞的电离辐射敏感性的影响及其作用机制。方法 DDX46基因RNA干扰慢病毒转染的SW480细胞为实验组,空载质粒慢病毒转染的SW480细胞为对照组。两组细胞转染72 h后,分别进行0和4 Gy X射线照射,采用CCK-8方法检测两组的细胞活力;实验组联合4 Gy X射线照射24 h后,采用免疫荧光技术和Western blot法检测细胞γ-H2AX foci数量以及DNA损伤修复通路关键蛋白的表达水平,确定DDX46与辐射诱导的DNA损伤修复的关系。结果 4 Gy X射线照射24 h后,实验组的细胞活力比照射前降低（15.02±3.92）%（t=-4.696,P<0.05）,比对照组降低（17.43±1.83）%（t=4.844,P<0.01）;而对照组照射前后比较差异无统计学意义（P>0.05）。同时,实验组γ-H2AX foci数量相比于对照组增加了（43.03±17.6）%（t=-3.108,P<0.05）,ATM的蛋白水平显著升高（t=7.530,P<0.01）,而ATM的活性形式p-ATM以及ATM的下游靶蛋白Rad50的蛋白水平则明显降低（t=4.260、4.260、P<0.05）,同时γ-H2AX的蛋白表达水平也有一定程度的升高（t=-3.090,P<0.05）,DNA-PK在两组细胞内的蛋白水平变化不大。结论 沉默DDX46可以提高结肠癌细胞系SW480的辐射敏感性,其机制可能是DDX46表达沉默抑制结肠癌细胞系SW480中ATM的活化,从而抑制辐射诱导的DNA损伤的修复,提高SW480的辐射敏感性。