Foo Serene S, Abbott David F, Lawrentschuk Nathan, Scott Andrew M
Ludwig Institute for Cancer Research, University of Melbourne, Austin Hospital, Victoria, Australia.
Mol Imaging Biol. 2004 Sep-Oct;6(5):291-305. doi: 10.1016/j.mibio.2004.06.007.
Tumor hypoxia plays a fundamental role in tumor progression and treatment resistance. Recent evidence that hypoxia also influences the regulation and transcription of various genes involved in malignant growth and metastases, and promotes a more aggressive tumor phenotype makes its diagnosis even more important.
The evidence for the biology of hypoxia in tumors, and imaging of hypoxia with different technologies was reviewed through literature review and Medline searches, and clinical studies with 18F-fluoromisonidazole (FMISO) Positron Emission Tomography (PET).
Until recently, determination of the level of tumor oxygenation was only possible using invasive methods that limited its clinical application. Imaging techniques that have shown promise in assessing hypoxia include magnetic resonance imaging and spectroscopy, single photon emission computed tomography (SPECT) and PET. Quantitative hypoxia measurement with 18F-FMISO PET in patients with malignant gliomas and lung cancer have demonstrated intratumoural hypoxia and dissociation of glucose metabolism from hypoxia in some cases, indicating the complex nature of cellular metabolic response to stress.
The emerging role of therapies that have improved efficacy in hypoxic conditions, and recent advances in the ability to noninvasively measure in vivo intratumoral hypoxia with functional imaging has renewed interest in the clinical measurement of tumor hypoxia and its impact on cancer treatment.
肿瘤缺氧在肿瘤进展和治疗抵抗中起着至关重要的作用。最近有证据表明，缺氧还会影响参与恶性生长和转移的各种基因的调控和转录，并促进更具侵袭性的肿瘤表型，这使得对其进行诊断变得更加重要。
通过文献综述和医学文献数据库检索，以及使用18F-氟米索硝唑（FMISO）正电子发射断层扫描（PET）的临床研究，对肿瘤缺氧生物学的证据以及用不同技术对缺氧进行成像的情况进行了综述。
直到最近，只有通过侵入性方法才能确定肿瘤氧合水平，这限制了其临床应用。在评估缺氧方面显示出前景的成像技术包括磁共振成像和光谱学、单光子发射计算机断层扫描（SPECT）和PET。对恶性胶质瘤和肺癌患者使用18F-FMISO PET进行定量缺氧测量，在某些情况下已证明肿瘤内存在缺氧以及葡萄糖代谢与缺氧的分离，这表明细胞对压力的代谢反应具有复杂性。
在缺氧条件下疗效有所改善的治疗方法的新作用，以及利用功能成像非侵入性测量体内肿瘤内缺氧能力的最新进展，重新激发了人们对肿瘤缺氧临床测量及其对癌症治疗影响的兴趣。
