Li Xiao-Feng, Taki Junichi, Kinuya Seigo, Higuchi Takahiro, Konishi Shota, Hwang Eui-Hyo, Shuke Noriyuki, Nakajima Kenichi, Tonami Norihisa
Department of Biotracer Medicine, Kanazawa University Graduate School of Medical Sciences, Japan.
Ann Nucl Med. 2003 Sep;17(6):489-93. doi: 10.1007/BF03006440.
The aim of the present study was to investigate asialoglycoprotein receptor (ASGP-R) status in tumor-bearing livers and early after their sectorial resection employing 99mTc-DTPA-galactosyl human serum albumin (99mTc-GSA) dynamic SPECT.
Ten normal liver controls and 44 liver tumor patients who underwent sectorial hepatectomy were included in the study. 99mTc-GSA dynamic SPECT study was performed 7 +/- 3 d before (pre-operative) and 34 +/- 13 d after surgery (post-operative) in liver tumour patients. Pre- and post-operative parameters including hepatic functional volume and 99mTc-GSA clearance of unit hepatic functional volume, representing ASGP-R concentration, were measured. The sum of functional volume of the sectors uninvolved in hepatectomy was defined as residual functional volume. Subsequently, post-operative change in functional volume (the ratio of post-operative to residual functional volume), post-operative change in 99mTc-GSA clearance of unit hepatic functional volume (the ratio of post- to pre-operative 99mTc-GSA clearance of unit hepatic functional volume) and percent resection of functional volume were calculated.
Pre-operative 99mTc-GSA clearance of unit hepatic functional volume in tumor-bearing livers was significantly lower than that in non-tumor bearing control liver. The ratio of post- to pre-operative 99mTc-GSA clearance of unit hepatic functional volume showed marked variation from 0.57 to 2.14, which negatively correlated with the percent resection of functional volume (r = -0.58, p < 0.0001). The ratio of post- to pre-operative 99mTc-GSA clearance of unit hepatic functional volume exhibited a negative correlation with the ratio of post-operative to estimated residual functional volume (r = -0.67, p < 0.0001).
ASGP-R concentration is reduced in the presence of liver tumor. ASGP-R concentration reveals variable changes early after sectorial resection; the change negatively correlates with percent resection of hepatic functional volume. Post-operative change in ASGP-R concentration negatively correlates with change in functional volume.
本研究的目的是利用99mTc-DTPA-半乳糖基人血清白蛋白（99mTc-GSA）动态SPECT研究荷瘤肝脏及其部分切除术后早期的去唾液酸糖蛋白受体（ASGP-R）状态。
本研究纳入了10名正常肝脏对照者和44例行部分肝切除术的肝肿瘤患者。对肝肿瘤患者在手术前7±3天（术前）和手术后34±13天（术后）进行99mTc-GSA动态SPECT研究。测量术前和术后参数，包括肝功能体积和单位肝功能体积的99mTc-GSA清除率，后者代表ASGP-R浓度。将未参与肝切除术的各肝段功能体积之和定义为残余功能体积。随后，计算术后功能体积的变化（术后与残余功能体积之比）、单位肝功能体积的99mTc-GSA清除率的术后变化（单位肝功能体积的术后与术前99mTc-GSA清除率之比）以及功能体积的切除百分比。
荷瘤肝脏单位肝功能体积的术前99mTc-GSA清除率显著低于非荷瘤对照肝脏。单位肝功能体积的术后与术前99mTc-GSA清除率之比在0.57至2.14之间有显著变化，与功能体积的切除百分比呈负相关（r = -0.58，p < 0.0001）。单位肝功能体积的术后与术前99mTc-GSA清除率之比与术后与估计残余功能体积之比呈负相关（r = -0.67，p < 0.0001）。
肝肿瘤存在时ASGP-R浓度降低。ASGP-R浓度在部分切除术后早期显示出可变变化；该变化与肝功能体积的切除百分比呈负相关。ASGP-R浓度的术后变化与功能体积的变化呈负相关。
