Nocuń Anna, Chrapko Beata, Gołębiewska Renata, Stefaniak Bogusław, Czekajska-Chehab Elżbieta
Department of Radiology and Nuclear Medicine, Medical University of Lublin, Poland.
Nucl Med Commun. 2011 Jun;32(6):522-9. doi: 10.1097/MNM.0b013e32834508b3.
Large cell pulmonary neuroendocrine carcinoma (LCNEC) is a poorly differentiated and high-grade neoplasm. It is positioned between an atypical carcinoid and small cell neuroendocrine carcinoma of the lung in a distinct family of pulmonary neuroendocrine tumors. The aim of our study was to detect somatostatin receptors in this uncommon malignancy and to evaluate the sensitivity of somatostatin receptor scintigraphy (SRS) in LCNEC staging.
We analyzed data of 26 patients (mean age: 61.5±7.9 years) with histologically confirmed diagnosis of LCNEC, including 18 cases not treated surgically and eight patients after the resection of the primary tumor. SRS was carried out with technetium-99m ethylene diamine-diacetic acid/hydrazinonicotinyl-Tyr3-octreotide (Tc-TOC). A visual analysis of scintigraphic images was done with reference to conventional imaging modalities (computed tomography and bone sicintigraphy).
SRS sensitivity for the detection of primary lesions, supradiaphragmatic metastases, and infradiaphragmatic metastases was 100, 83.3%, and 0%, respectively. Five out of 13 metastases to the liver appeared on SRS as photopenic foci, visible on the background of physiological hepatic activity. Only one of the nine metastases to the skeletal system was found by SRS with sensitivity as low as 11.1%. The overall SRS sensitivity for the detection of secondary lesions and of all lesions was 54.8 and 62.2%, respectively.
Within a rather large series of LCNEC, the primary tumor showed an uptake of Tc-TOC in all cases, whereas some metastases did show Tc-TOC uptake and some others did not.
大细胞肺神经内分泌癌（LCNEC）是一种低分化的高级别肿瘤。它在肺神经内分泌肿瘤的一个独特类别中，介于非典型类癌和肺小细胞神经内分泌癌之间。我们研究的目的是检测这种罕见恶性肿瘤中的生长抑素受体，并评估生长抑素受体闪烁显像（SRS）在LCNEC分期中的敏感性。
我们分析了26例经组织学确诊为LCNEC患者的数据（平均年龄：61.5±7.9岁），其中18例未接受手术治疗，8例为原发肿瘤切除术后患者。使用锝-99m乙二胺二乙酸/肼基烟酰基-Tyr3-奥曲肽（Tc-TOC）进行SRS检查。参照传统成像方式（计算机断层扫描和骨闪烁显像）对闪烁显像图像进行视觉分析。
SRS检测原发灶、膈上转移灶和膈下转移灶的敏感性分别为100%、83.3%和0%。肝脏的13处转移灶中有5处在SRS上表现为放射性缺损灶，在生理性肝脏活性背景下可见。骨骼系统的9处转移灶中只有1处被SRS发现，敏感性低至11.1%。SRS检测继发灶和所有病灶的总体敏感性分别为54.8%和62.2%。
在一系列相当大的LCNEC病例中，所有病例的原发肿瘤均显示摄取Tc-TOC，而一些转移灶显示摄取Tc-TOC，另一些则未显示。
