Lim S C, Park K O, Kim Y C, Na K J, Song H, Bom H S
Department of Internal Medicine, Chonnam University Hospital, Kwangju, Korea.
Cancer Biother Radiopharm. 2000 Aug;15(4):381-6. doi: 10.1089/cbr.2000.15.381.
Neuron-specific enolase (NSE) and lactate dehydrogenase (LDH) are tumor markers of small cell lung cancer (SCLC) which were reported to predict outcome of patients with SCLC. We previously reported that dipyridamole-modulated Tc-99m sestamibi (dipyridamole-MIBI) single photon emission computed tomography (SPECT) could predict the response to chemotherapy in SCLC patients. The purpose of this study was to compare dipyridamole-MIBI and pretreatment serum levels of NSE and LDH for the prediction of response to chemotherapy in SCLC. Twenty-eight SCLC patients underwent dipyridamole-MIBI SPECT 3 to 7 days before starting chemotherapy (80 mg/m2 etoposide and 80 mg/m2 cisplatin every 3 or 4 weeks for at lease two cycles). Serum levels of NSE and LDH were also measured at the same day of the imaging. Tomographic images before and after 0.84 mg/kg dipyridamole infusion were acquired 1 hour after injection of 370 (10 mCi) and 1,110 (30 mCi) MBq MIBI, respectively. The response to chemotherapy was grouped as specified as complete (CR), partial response (PR), no change (NC), and progressive disease (PD), according to the change in tumor size on chest roentgenography and CT. Patients showing CR and PR were classified as responders, and those who showed NC and PD were considered nonresponders. Among the 28 patients, 15 were responders (2 CR, 13 PR) and 13 were nonresponders (11 NC, 2 PD). The change of tumor-to-normal lung ratio (T:NL) after infusion of dipyridamole was significantly higher in responders as compared with nonresponders (0.38 +/- 0.64 vs. -0.38 +/- 0.50, respectively, p = 0.002). However, pretreatment serum NSE and LDH levels did not correlate with the response to chemotherapy. Increase of T:NL after dipyridamole infusion was a strong negative predictor of chemotherapeutic response in SCLC patients, while NSE and LDH could not predict it.
神经元特异性烯醇化酶（NSE）和乳酸脱氢酶（LDH）是小细胞肺癌（SCLC）的肿瘤标志物，据报道可预测SCLC患者的预后。我们之前报道过双嘧达莫调节的锝-99m 甲氧基异丁基异腈（双嘧达莫-MIBI）单光子发射计算机断层扫描（SPECT）可预测SCLC患者对化疗的反应。本研究的目的是比较双嘧达莫-MIBI以及NSE和LDH的治疗前血清水平，以预测SCLC患者对化疗的反应。28例SCLC患者在开始化疗前3至7天接受双嘧达莫-MIBI SPECT检查（每3或4周给予80 mg/m²依托泊苷和80 mg/m²顺铂，至少两个周期）。在成像当天还检测了NSE和LDH的血清水平。分别在注射370（10 mCi）和1,110（30 mCi）MBq MIBI后1小时，采集静脉注射0.84 mg/kg双嘧达莫前后的断层图像。根据胸部X线和CT检查中肿瘤大小的变化，将化疗反应分为完全缓解（CR）、部分缓解（PR）、无变化（NC）和疾病进展（PD）。显示CR和PR的患者被归类为反应者，而显示NC和PD的患者被视为无反应者。在这28例患者中，15例为反应者（2例CR，13例PR），13例为无反应者（11例NC，2例PD）。与无反应者相比，反应者在静脉注射双嘧达莫后肿瘤与正常肺组织的比值（T:NL）变化显著更高（分别为0.38±0.64和-0.38±0.50，p = 0.002）。然而，治疗前血清NSE和LDH水平与化疗反应无关。双嘧达莫注射后T:NL的增加是SCLC患者化疗反应的强阴性预测指标，而NSE和LDH无法预测。
