Cascini G L, Cuccurullo V, Mansi L
Department of Radiological Sciences,, University of Catanzaro, Catanzaro, Italy.
Q J Nucl Med Mol Imaging. 2010 Feb;54(1):24-36.
The use of somatostatin (SS) analogues in humans takes advantage by the availability of many related chemical forms that can be used for receptor therapy and, after radiolabelling, for diagnostic imaging and radionuclide therapy. The first proposed radiocompound, yet clinically widely diffuse, has been (111)In-octreotide (OCT), followed by positron emission tomography (PET) and beta emitter tracers. The main field of clinical applications is in neuroendocrine tumours (NET), starting by the demonstration of SS receptors (SSR) on the majority of NET, particularly on gastroenteropancreatic (GEP) tumours. Uptake of SS analogues can also be due to a SSR expression on non malignant cells when activated, as lymphocytes, macrophages, fibroblasts , vascular cells. Because of this uptake clinical indications can be found also in active benign diseases, as Grave's ophthalmopathy, rheumatoid arthritis, histiocitosis, sarcoidosis, idiopatic pulmonary fibrosis. Moreover, these cells can also determine the OCT in vivo uptake in tumours non expressing in vitro SSR, as non-snall cell lung cancer (NSCLC). Because of a different kinetic respect to SCLC a differential histotype diagnosis could be obtained. Starting from this premise OCT can also allows radioguided surgery in tumours non expressing SSR. Finally a relevant clinical role can be defined in the a priori recruitment and as marker of therapeutic efficacy in all the therapeutic strategies utilizing SSR, both in malignant and benign diseases.
生长抑素(SS)类似物在人类中的应用利用了多种相关化学形式的可用性,这些形式可用于受体治疗,经放射性标记后可用于诊断成像和放射性核素治疗。首个被提出的放射性化合物,也是临床上广泛应用的,是(111)铟奥曲肽(OCT),随后出现了正电子发射断层扫描(PET)和β发射体示踪剂。临床应用的主要领域是神经内分泌肿瘤(NET),这始于在大多数NET上,特别是在胃肠胰(GEP)肿瘤上发现生长抑素受体(SSR)。当被激活时,非恶性细胞如淋巴细胞、巨噬细胞、成纤维细胞、血管细胞上的SSR表达也可导致SS类似物的摄取。因此,在一些活动性良性疾病如格雷夫斯眼病、类风湿性关节炎、组织细胞增多症、结节病、特发性肺纤维化中也能找到临床应用指征。此外,这些细胞还可决定体外不表达SSR的肿瘤如非小细胞肺癌(NSCLC)中OCT的体内摄取。由于与小细胞肺癌(SCLC)的动力学不同,可获得不同组织学类型诊断。基于这一前提,OCT还可用于不表达SSR的肿瘤的放射性引导手术。最后,在所有利用SSR的治疗策略中,无论是恶性还是良性疾病,OCT在预先招募和作为治疗疗效标志物方面都可发挥重要的临床作用。