Hoebers Frank J P, Kartachova Marina, de Bois Josien, van den Brekel Michiel W M, van Tinteren Harm, van Herk Marcel, Rasch Coen R N, Valdés Olmos Renato A, Verheij Marcel
Department of Radiotherapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, The Netherlands,
Eur J Nucl Med Mol Imaging. 2008 Mar;35(3):509-18. doi: 10.1007/s00259-007-0624-x. Epub 2007 Nov 10.
The purpose of this study was to determine the value of (99m)Tc Hynic-rh-Annexin-V-Scintigraphy (TAVS), a non-invasive in vivo technique to demonstrate apoptosis in patients with head and neck squamous cell carcinoma.
TAVS were performed before and within 48 h after the first course of cisplatin-based chemoradiation. Radiation dose given to the tumour at the time of post-treatment TAVS was 6-8 Gy. Single-photon emission tomography data were co-registered to planning CT scan. Complete sets of these data were available for 13 patients. The radiation dose at post-treatment TAVS was calculated for several regions of interest (ROI): primary tumour, involved lymph nodes and salivary glands. Annexin uptake was determined in each ROI, and the difference between post-treatment and baseline TAVS represented the absolute Annexin uptake: Delta uptake (DeltaU).
In 24 of 26 parotid glands, treatment-induced Annexin uptake was observed. Mean DeltaU was significantly correlated with the mean radiation dose given to the parotid glands (r = 0.59, p = 0.002): Glands that received higher doses showed more Annexin uptake. DeltaU in primary tumour and pathological lymph nodes showed large inter-patient differences. A high correlation was observed on an inter-patient level (r = 0.71, p = 0.006) between the maximum DeltaU in primary tumour and in the lymph nodes.
Within the dose range of 0-8 Gy, Annexin-V-scintigraphy showed a radiation-dose-dependent uptake in parotid glands, indicative of early apoptosis during treatment. The inter-individual spread in Annexin uptake in primary tumours could not be related to differences in dose or tumour volume, but the Annexin uptake in tumour and lymph nodes were closely correlated. This effect might represent a tumour-specific apoptotic response.
本研究旨在确定（99m）Tc 标记的 Hynic-rh-膜联蛋白 V 闪烁显像（TAVS）的价值，这是一种用于显示头颈部鳞状细胞癌患者体内凋亡情况的非侵入性体内技术。
在以顺铂为基础的放化疗第一疗程之前及之后 48 小时内进行 TAVS。治疗后 TAVS 时给予肿瘤的辐射剂量为 6 - 8 戈瑞。单光子发射断层扫描数据与计划 CT 扫描进行配准。13 例患者可获得完整的这些数据。针对几个感兴趣区域（ROI）计算治疗后 TAVS 时的辐射剂量：原发肿瘤、受累淋巴结和唾液腺。在每个 ROI 中测定膜联蛋白摄取情况，治疗后与基线 TAVS 之间的差异代表绝对膜联蛋白摄取：Δ摄取量（ΔU）。
在 26 个腮腺中的 24 个观察到治疗诱导的膜联蛋白摄取。平均 ΔU 与给予腮腺的平均辐射剂量显著相关（r = 0.59，p = 0.002）：接受较高剂量的腺体显示出更多的膜联蛋白摄取。原发肿瘤和病理淋巴结中的 ΔU 在患者间差异较大。在患者间水平上观察到原发肿瘤和淋巴结中最大 ΔU 之间存在高度相关性（r = 0.71，p = 0.00第六感官网6）。
在 0 - 8 戈瑞的剂量范围内，膜联蛋白 V 闪烁显像显示腮腺中存在辐射剂量依赖性摄取，表明治疗期间早期凋亡。原发肿瘤中膜联蛋白摄取的个体间差异与剂量或肿瘤体积差异无关，但肿瘤和淋巴结中的膜联蛋白摄取密切相关。这种效应可能代表肿瘤特异性凋亡反应。
