生长抑素受体显像与肿瘤的诊断和治疗

受体和配体的结合具有高度的特异性和组织专一性，研究发现多种肿瘤组织表达高密度的生长抑素受体(SSTR)，放射性核素标记的生长抑素可以与肿瘤细胞膜上的生长抑素受体特异性结合，通过放射性核素的介导作用对肿瘤进行定位和诊断。口射线可以直接杀伤相应的肿瘤细胞起内辐射的治疗作用。     

放射性核素标记奥曲肽肿瘤受体显像研究进展

放射性核素标记奥曲肽（octreotide）能与多种肿瘤组织的生长抑素受体特异性地结合,可定性、定位诊断生长抑素受体阳性肿瘤.现综述奥曲肽生物学特点与功能、生长抑素受体的表达、不同的放射性核素标记奥曲肽诊断肿瘤的优缺点及放射性核素标记奥曲肽肿瘤受体显像的应用进展.     

肺癌生长抑素受体表达与其靶向显像的相关性研究

目的:探讨肺癌组织生长抑素受体(SSTR)表达水平与99Tcm-depreotide生长抑素受体显像对肿瘤的靶向诊断价值及两者的相关性。方法:46例肺癌患者(纤支镜或CT引导下穿刺确诊)静脉推注99Tcm-depreotide(740±60)MBq后4～6h行平面及胸部断层SPECT显像,重建后获得发射-透射图像。勾画感兴趣区,计算肿瘤和对侧相应部位正常肺组织的放射性比值(T/N),所有病灶均经病理检查确诊。用SP法检测肿瘤组织SSTR的表达水平,对其表达水平与T/N比值进行相关性分析。结果:43例肺癌患者清晰显影,瘤组织有较高的局灶性放射性浓聚;3例显像阴性。6h小细胞肺癌(SCLC)和非小细胞肺癌(NSCLC)组T/N分别为1.948±0.282、1.280±0.160,SCLC对99Tcm-depreotide的摄取明显高于NSCLC,t=0.130,P<0.05。免疫组化表明,肿瘤组织有SSTR表达,与肿瘤显像阳性者T/N比值呈正相关,r=0.853,P<0.01和r=0.615,P<0.05。结论:99Tcm-depreotide受体显像对肺肿瘤有很好的靶向诊断价值;肺癌组织有SSTR表达。99Tcm-depreotide肿瘤摄取程度同SSTR表达水平正相关。     

放射性核素标记奥曲肽肿瘤受体显像研究进展

放射性核素标记奥曲肽(octreotide)能与多种肿瘤组织的生长抑素受体特异性地结合,可定性、定位诊断生长抑素受体阳性肿瘤.现综述奥曲肽生物学特点与功能、生长抑素受体的表达、不同的放射性核素标记奥曲肽诊断肿瘤的优缺点及放射性核素标记奥曲肽肿瘤受体显像的应用进展.     

生长抑素及其受体与消化系肿瘤

生长抑素 ( SS)是一种环状的多肽类激素 ,广泛存在于人体的内分泌及外分泌系统中 ,在人体内具有广泛的生物学效应 ,主要表现抑制作用 ,它对人体多种激素的分泌具有重要的调节作用。近年来 ,生长抑素对肿瘤的抑制作用日益受到人们的关注。大量研究表明生长抑素及其类似物不仅能抑制内分泌肿瘤的增殖 ,对消化系实体性肿瘤亦存在抑制作用。本文就其在消化系肿瘤中作用及其机制 ,作一综述。一、生长抑素及其受体天然的生长抑素一般指生长抑素 1 4肽 ( SS- 1 4)和生长抑素 2 8肽 ( SS- 2 8) ,两者由一个前体蛋白 ( 92肽 )在不同分泌细胞中以不…     

生长抑素和生长抑素受体与肺癌

受体和配体的结合具有高度的特异性和组织专一性,研究发现肺癌组织中表达生长抑素受体(SSTR),通过放射性核素标记的生长抑素(SS)可以与细胞膜上SSTR特异性结合,通过放射性核素的介导作用对肺癌进行定位和诊断,与放化疗结合发挥抗肿瘤作用。     

乳腺癌EGF受体核素显像诊断和靶向治疗

目前临床上早期诊断及治疗乳腺癌的方法存在着各种局限性,非侵袭性表皮生长因子受体(EGFR)介导的放射性核素显像诊断及核素靶向治疗,以其独到的功能显像和分子治疗展示了未来乳腺癌早期定性诊断和微创治疗的美好前景.现综述乳腺癌EGFR核素显像诊断和核素靶向治疗的研究进展.     

胰腺癌生长抑素受体报告基因表达与其靶向显像的相关性研究

目的探讨荷胰腺癌裸鼠模型肿瘤组织生长抑素受体(SSTR)报告基因的mRNA表达水平与99mTc-sandostatin显像对肿瘤的靶向诊断价值及二者的相关性。方法建立荷胰腺癌动物模型,对18只荷胰腺癌裸鼠模型行99mTc-sandostatin显像,勾画感兴趣区,计算瘤体与对侧正常组织的放射性比值(T/NT),用RT-PCR方法检测肿瘤组织SSTR1、SSTR2、SSTR5 mRNA的表达水平,对各SSTR亚型表达水平与T/NT比值进行相关性分析。结果13只荷胰腺癌裸鼠肿瘤清晰显影,瘤组织有较高的局灶性放射性浓聚;6 h T/NT比值达2.53±0.84。5只荷胰腺癌裸鼠显像弱阳性或阴性,6 hT/NT比值为1.04±0.06。肿瘤组织有SSTR1、SSTR2、SSTR5 mRNA表达,SSTR1、SSTR2的表达水平与肿瘤显像阳性裸鼠T/NT比值呈正相关,r分别为0.597(P<0.05)和0.807(P<0.01)。结论荷胰腺癌裸鼠肿瘤组织有SSTR表达,SSTR2尤为显著9。9mTc-sandostatin受体显像对荷胰腺癌动物模型有很好的靶向诊断价值;肿瘤99mTc-sandostatin摄取程度同SSTR1、SSTR2表达水平正相关。     

生长抑素和生长抑素受体与肺癌

受体和配体的结合具有高度的特异性和组织专一性,研究发现肺癌组织中表达生长抑素受体（SSTR）,通过放射性核素标记的生长抑素（SS）可以与细胞膜上SSTR特异性结合,通过放射性核素的介导作用对肺癌进行定位和诊断,与放化疗结合发挥抗肿瘤作用。     

生长抑素受体在肿瘤研究中的新进展

生长抑素（somatostatin，SST）全称为促生长激素抑制素，是1种环状多肽，广泛分布于胃肠道及中枢神经系统。近年的研究显示生长抑素不仅具有广泛的生理功能，还具有抑制肿瘤的作用，现就生长抑素受体在肿瘤研究中的新进展作一综述。     

A possible role for somatostatin receptor scintigraphy in the diagnosis and follow-up of children with medulloblastoma

The surgical resection of medulloblastoma (MB), the most frequent malignant brain tumor in children, often remains subtotal. To estimate the response to further treatment the residual tumor is monitored by CT or MRI. The interpretation of both imaging techniques is complicated by disturbances resulting from surgery and radiation. Our study searched for alternative imaging techniques and asked the following questions. 1) Do MB express somatostatin receptors (SSTR), 2) is SSTR scintigraphy a sensitive imaging technique for the follow-up and the detection of vital tumor tissue in children with MB, and 3) do the results of SSTR scintigraphy correlate with the in vitro analysis of MB tissue by SSTR autoradiography. We analyzed the SSTR status in 20 children with MB, aged 1 to 15 years. Sixteen SSTR scintigraphies using Indium-111-DTPA-D-Phel-pentetreotide were performed in 14 children. MB tissue of 14 children was analyzed by SSTR autoradiography using Iodine-125-Tyr3-octreotide. In 8 cases SSTR were measured by both methods in vivo and in vitro. In comparison with conventional imaging, results of SSTR scintigraphy were true positive in 7 of 7 patients, true negative in 9 of 9 patients, including one patient with false positive findings in MRI, false negative in only one patient with small spinal metastases (diameter < 3 mm) and false positive in none of the analyzed patients. In all cases with residual tumor (n = 3) and suspected relapse (n = 4) the diagnosis could be confirmed (n = 4) or excluded (n = 3), consistent with the results of MRI and tumor histology. All MB tissues analyzed by SSTR autoradiography (n = 14) showed an extremely high density of SSTR ranging from 4047 to 15526 dpm/mg MB tissue. MB (n = 8) which were analyzed by SSTR scintigraphy and autoradiography demonstrated consistent results in evaluation by both methods. In cases where the integrity of the blood-brain barrier was tested by Tc-99m-DTPA scintigraphy (n = 10), the SSTR-to-brain scintigraphy index confirmed the tumor specificity of radionuclide uptake. We conclude that 1) MB tissue expresses a particularly high density of SSTR, 2) the high density of SSTR in autoradiography correlates with a sensitive imaging of these tumors by SSTR scintigraphy, 3) SSTR scintigraphy might be a valuable imaging method for detection of vital MB tissue in patients with residual tumor or relapse.     

Utility of radiolabeled somatostatin receptor analogues for staging/restaging and treatment of somatostatin receptor-positive pediatric tumors

In this paper, we review the pediatric oncologic applications of somatostatin receptor-targeted imaging and therapy. Somatostatin receptors are expressed in high densities by embryonal tumors, such as neuroblastoma and medulloblastoma, and neuroendocrine tumors like carcinoids and islet cell tumors. We first review the distribution of these receptors in normal tissues and tumor cells. We then discuss the technique of somatostatin receptor scintigraphy (SRS) in the pediatric population. Next, the specific clinical applications of SRS with regard to the imaging of neuroblastoma, central nervous system tumors, and gastroenteropancreatic neuroendocrine tumors of childhood are discussed. Finally, we discuss the potential role of somatostatin receptor-targeted radiotherapy for improving the duration and quality of life of children with these tumors.     

小细胞肺癌细胞SSTR2的体外分布及受体显像

目的:探讨生长抑素受体亚型2(somatostatin receptor 2 subtype,SSTR2)在体外培养的小细胞肺癌(small cell lungcancer,SCLC)NCI-H446细胞中的表达和分布,以及99mTc-octreotide受体显像对SCLC的诊断价值.方法:应用电子显微镜放射自显影(electron microscope radioautography,EMR)技术,采用125I-octreotide观察SSTK2在SCLC细胞中的分布与表达;自荷人NCI-H446 SCLC裸鼠尾静脉注射0.15mL、活度为16.8MBq的99mTc-octreotide,观察裸瘤鼠模型99mTc-octreotide受体显像的变化.结果:电子显微镜下30 min及120 min组的细胞银颗粒标记率分别为95%(19/20)和80.0%(16/20),2者比较差异有统计学意义(P<0.05);30 min组银颗粒主要分布干细胞膜区,120 min组银颗粒主要分布于细胞质和细胞核区.过量加入Tyr-3-octreotide的对照组中银颗粒数明显少于其对应的未加过量组.5例荷瘤裸鼠的受体显像均呈阳性,且在注射99mTc-oct-reotide4 h后肿瘤显像最清晰.结论:SCLC肿瘤细胞中高表达SSTR2,octreotide受体显像可能成为一种新的早期探测SCLC的方法.     

99Tcm-奥曲肽显像在肺癌诊断中的应用

目的 探讨99Tcm-奥曲肽显像对肺癌的临床诊断意义.方法 30例CT检查被怀疑为肺部肿瘤的患者行99Tcm-奥曲肽显像,计算肿瘤病灶和对侧正常肺组织的摄取比值(T/N)并做半定量分析.结果 99Tcm-奥曲肽显像诊断肺癌的灵敏度、特异度和准确度分别为95.7%、71.4%和90.0%.30例患者中,有24例99Tcm-奥曲肽显像为阳性,其中2例为假阳性;6例患者诊断为阴性,其中1例为假阴性.99Tcm-奥曲肽显像共检出阳性病灶46个,其中3个为超声和CT检查未发现的病灶.小细胞肺癌(SCLC)组的T/N(2.78±1.07)明显高于非小细胞肺癌(NSCLC)组(1.75±0.31,t=3.82,P<0.05).结论 99Tcm-奥曲肽显像能够显示肺癌细胞表面的生长抑素受体(SSTR),对肺癌原发灶和转移灶具有一定的诊断价值;99Tcm-奥曲肽显像更有利于SCLC的检测,可作为常规显像方法的一种有效补充.     

Staging of digestive endocrine tumours using helical computed tomography and somatostatin receptor scintigraphy.

BACKGROUND: In patients with digestive endocrine tumours, complete pre-operative staging is essential in planning proper management and evaluating treatment efficacy. To date, somatostatin receptor scintigraphy (SRS) is considered the 'gold standard' imaging procedure, and very few data are available concerning the use of helical computed tomography (hCT). This study aimed to determine the diagnostic accuracy and the ability to modify the surgical management of hCT, alone or combined with SRS. PATIENTS AND METHODS: Sixty patients were staged before surgery by hCT, SRS and tumour markers, and included in group 1 if suitable for radical surgery, otherwise in group 2. All patients underwent laparotomy followed by subsequent re-staging. RESULTS: SRS sensitivity was 77%, 48% and 67% for primary, lymph-node and liver lesions, respectively. hCT sensitivity was 94%, 69% and 94% for primary, lymph-node and liver lesions, respectively (P = 0.02 versus SRS, for liver lesions). During pre-operative evaluation, hCT correctly staged 92% and SRS 75% of patients (P = 0.02). hCT provided additional information in 17% of patients. CONCLUSIONS: Since hCT has been shown to be extremely accurate, providing essential information for the planning of surgical treatment compared with that of SRS, both techniques should be used in the pre-operative work-up of digestive endocrine tumours.