Mineura K, Shioya H, Kowada M, Ogawa T, Hatazawa J, Uemura K
Neurosurgical Service, Akita University Hospital, Japan.
J Neurooncol. 1999 May;43(1):49-57. doi: 10.1023/a:1006296729019.
To accurately characterize the pathophysiology and proliferating activity of oligodendrogliomas, we studied cerebral blood flow and metabolism using positron emission tomography (PET) in five patients with this tumor. Regional cerebral blood flow (rCBF), cerebral blood volume (rCBV), oxygen extraction fraction (rOEF), and cerebral metabolic rates of oxygen (rCMRO2) and of glucose (rCMRGl) were quantitatively measured in tumor lesions and the contralateral gray matter, rCMRGl was analyzed based on both kinetic and autoradiographic methods. Tumor rCBF and rCBV were lower than in the contralateral gray matter in all preoperatively examined patients. Oxygen metabolism, determined by rCMRO2 and rOEF, was consistently reduced in the tumor (rCMRO2, P<0.05 vs. gray matter, determined by the Student's t-test). Tumor rCMRGl was significantly lower than the gray matter rCMRGl in both kinetic (P<0.01) and autoradiographic (P<0.05) analyses. Kinetic tumor rCMRGl varied between 1.22 and 4.13 mg/100 ml/min, but was lower than the gray matter value in all patients. Autoradiographic tumor rCMRGl, which ranged from 1.02 to 5.79 mg/100 ml/min, was also reduced in all tumors but one; the remaining tumor, which had a relatively high value of autoradiographic rCMRGl (comparable to gray matter rCMRGl), infiltrated the contralateral hemisphere through the corpus callosum, and was characterized by high cellular density. In one patient who suffered from tumor recurrence 8 years and 10 months after initial treatment, phosphorylation constant (K3) and kinetic rCMRGl of the recurring tumor were higher than those of the original tumor. No other tumors have regrown or recurred during the postoperative follow-up periods, which ranged from 22 to 130 months (median = 101 months). Circulation and metabolism measured by PET provide in vivo biological characteristics, including proliferating activity, in oligodendrogliomas.
为准确描述少突胶质细胞瘤的病理生理学和增殖活性，我们对5例患有该肿瘤的患者使用正电子发射断层扫描（PET）研究了脑血流量和代谢情况。对肿瘤病灶和对侧灰质进行了局部脑血流量（rCBF）、脑血容量（rCBV）、氧摄取分数（rOEF）以及脑氧代谢率（rCMRO2）和葡萄糖代谢率（rCMRGl）的定量测量，rCMRGl基于动力学和放射自显影方法进行分析。在所有术前检查的患者中，肿瘤的rCBF和rCBV均低于对侧灰质。由rCMRO2和rOEF测定的氧代谢在肿瘤中持续降低（rCMRO2，与灰质相比，P<0.05，采用学生t检验）。在动力学分析（P<0.01）和放射自显影分析（P<0.05）中，肿瘤rCMRGl均显著低于灰质rCMRGl。动力学肿瘤rCMRGl在1.22至4.13mg/100ml/min之间变化，但在所有患者中均低于灰质值。放射自显影肿瘤rCMRGl范围为1.02至5.79mg/100ml/min，除1例肿瘤外，所有肿瘤均降低；其余肿瘤的放射自显影rCMRGl值相对较高（与灰质rCMRGl相当），通过胼胝体浸润对侧半球，其特征为细胞密度高。1例患者在初始治疗后8年10个月出现肿瘤复发，复发肿瘤的磷酸化常数（K3）和动力学rCMRGl高于原发肿瘤。在术后22至130个月（中位数=101个月）的随访期间，无其他肿瘤复发或再生长。PET测量的循环和代谢提供了少突胶质细胞瘤的体内生物学特征，包括增殖活性。
