99mTc-司他米比闪烁扫描术在提示胃癌化疗疗效方面的实用性。

Usefulness of 99mTc-sestamibi scintigraphy in suggesting the therapeutic effect of chemotherapy against gastric cancer.

作者信息

Kawata Kenji, Kanai Michiyuki, Sasada Tetsuro, Iwata Shingo, Yamamoto Naritaka, Takabayashi Arimichi

机构信息

Department of Surgery, Tazuke-Kofukai Medical Research Institute and Kitano Hospital, Osaka, Japan.

出版信息

Clin Cancer Res. 2004 Jun 1;10(11):3788-93. doi: 10.1158/1078-0432.CCR-1072-3.

DOI:10.1158/1078-0432.CCR-1072-3

PMID:15173086

Abstract

PURPOSE

Imaging with (99m)Tc-sestamibi ((99m)Tc-MIBI) has been used to assess 170-kDa P-glycoprotein (P-gp) expression and predict chemotherapy responses in several types of malignancy, such as breast and lung cancers. The purpose of this study was to evaluate the relationship between (99m)Tc-MIBI accumulation in tumors and sensitivity to chemotherapy in gastric cancer patients.

EXPERIMENTAL DESIGN

Thirty-six patients with advanced gastric cancer underwent (99m)Tc-MIBI scintigraphy before chemotherapy. Patients also underwent endoscopic biopsy, and the expression of P-gp or multidrug resistance-associated protein was analyzed by immunohistochemical staining. The relationship between the accumulation of (99m)Tc-MIBI in tumors and responses to chemotherapy with 5-fluorouracil/cis-diamminedichloroplatinum(II) or epirubicin was examined.

RESULTS

Higher accumulation of (9m)Tc-MIBI in tumors was observed in 25 and 23 of 36 gastric cancer patients at the early (30 min) and delayed (120 min) images, respectively. Accelerated accumulation of (99m)Tc-MIBI negatively correlates with increased expression of P-gp, but not of multidrug resistance-associated protein, as determined by immunohistochemistry in gastric cancer tissues. The response rate to 5-fluorouracil/cis-diamminedichloroplatinum(II) chemotherapy in patients with high (99m)Tc-MIBI accumulation (15.4%) was much lower than that in patients with low (99m)Tc-MIBI accumulation (54.5%). In contrast, patients with high (99m)Tc-MIBI accumulation show a higher response rate (41.7%) to chemotherapy with epirubicin, which is known to be a substrate of P-gp transporter.

CONCLUSIONS

(99m)Tc-MIBI scintigraphy is useful to suggest the responses to chemotherapy of patients with advanced gastric cancer.

摘要

目的

用（99m）锝-甲氧基异丁基异腈（（99m）Tc-MIBI）成像已被用于评估170-kDa P-糖蛋白（P-gp）表达，并预测多种恶性肿瘤（如乳腺癌和肺癌）的化疗反应。本研究的目的是评估胃癌患者肿瘤中（99m）Tc-MIBI摄取与化疗敏感性之间的关系。

实验设计

36例晚期胃癌患者在化疗前接受了（99m）Tc-MIBI闪烁扫描。患者还接受了内镜活检，并通过免疫组织化学染色分析P-gp或多药耐药相关蛋白的表达。研究了肿瘤中（99m）Tc-MIBI摄取与5-氟尿嘧啶/顺二氨二氯铂（II）或表柔比星化疗反应之间的关系。

结果

在36例胃癌患者中分别有25例和23例在早期（30分钟）和延迟（120分钟）图像上观察到肿瘤中（9m）Tc-MIBI摄取较高。通过胃癌组织免疫组织化学测定，（99m）Tc-MIBI的加速摄取与P-gp表达增加呈负相关，但与多药耐药相关蛋白表达无关。（99m）Tc-MIBI摄取高的患者对5-氟尿嘧啶/顺二氨二氯铂（II）化疗的反应率（15.4%）远低于（99m）Tc-MIBI摄取低的患者（54.5%）。相反，（99m）Tc-MIBI摄取高的患者对已知为P-gp转运体底物的表柔比星化疗的反应率较高（41.7%）。