使用 [18F] 3'-脱氧-3-氟胸苷正电子发射断层扫描/计算机断层扫描成像对卵巢癌进行非侵入性细胞增殖评估。
Noninvasive assessment of cell proliferation in ovarian cancer using [18F] 3'deoxy-3-fluorothymidine positron emission tomography/computed tomography imaging.
机构信息
Department of Obstetrics, Gynecology and Reproductive Services, Division of Gynecologic Oncology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
出版信息
Nucl Med Biol. 2011 May;38(4):485-91. doi: 10.1016/j.nucmedbio.2010.12.003. Epub 2011 Mar 3.
INTRODUCTION
Positron emission tomography (PET)/computed tomography (CT) imaging of suspected new and recurrent ovarian carcinoma was performed to assess the relationship between [(18)F] 3'deoxy-3'fluorothymidine ((18)FLT) uptake and histopathological tissue markers of cellular proliferation (Ki67) and thymidine kinase-1 (TK-1) expression.
METHODS
Six subjects were included in this pilot study. Subjects were injected with 5 mCi of (18)FLT prior to a planned surgery and then scanned on a GE Discovery-ST PET/CT scanner within an hour of injection. Regions of interest in tumor and control tissue were identified on the diagnostic CT scans and marked for later surgical biopsy. Surgery was performed within 2 days after the scan. At the time of surgery, the regions of interest identified on PET/CT were available to guide the surgeon to the tumor biopsy sites. Tissue from normal ovarian tissue control regions was also sampled. (18)FLT uptake in tumor and control tissue regions was calculated by measuring the maximum standardized uptake values (SUV(max)). The excised tumor and normal ovarian tissue control tissues were analyzed by immunohistochemical staining for Ki67 and CD34. TK-1 messenger RNA expression was measured by real-time polymerase chain reaction.
RESULTS
(18)FLT uptake (SUV(max)) was higher in malignant (mean 4.85/range 1.7-8.8) compared to benign (1.65/range 1.4-1.9) and normal ovarian control tissue (1.12/range 0.6-1.5). Mitotic index, as determined by Ki67 staining, was higher in malignant (18.89/range 11.97-27.19) compared to benign (0.59/range 0.23-0.95) and control tissue (0.45/range 0.06-1.20). TK-1 expression was also higher in malignant (35.52/range 5.21-106.62) compared to benign (8.71/range 4.74-12.67) and control tissue (9.79/range 0.85-39.46). An increasing trend between (18)FLT uptake and Ki67 mitotic index is seen in malignant tissue CD 34 staining between malignant, benign and control tissues was not qualitatively different.
CONCLUSION
An increasing trend between (18)FLT uptake and Ki67 mitotic index is seen in malignant tissue. Additional studies will determine whether (18)FLT PET/CT is specific enough to distinguish between cancerous and noncancerous cells and to assess its role in ovarian carcinoma patient management.
介绍
对疑似新发和复发性卵巢癌患者进行正电子发射断层扫描（PET）/计算机断层扫描（CT）成像，以评估[18F] 3'-脱氧-3'氟胸苷（[18]FLT）摄取与细胞增殖的组织学标志物（Ki67）和胸苷激酶-1（TK-1）表达之间的关系。
方法
本研究纳入 6 名受试者。受试者在计划手术前注射 5mCi [18]FLT，然后在注射后 1 小时内在 GE Discovery-ST PET/CT 扫描仪上进行扫描。在诊断 CT 扫描上识别肿瘤和对照组织的感兴趣区域，并标记以供以后的手术活检。手术在扫描后 2 天内进行。在手术时，PET/CT 上识别的感兴趣区域可用于指导外科医生进行肿瘤活检部位。还对正常卵巢组织对照区域进行了取样。通过测量最大标准化摄取值（SUV（max））来计算肿瘤和对照组织区域的[18]FLT 摄取。通过免疫组织化学染色分析切除的肿瘤和正常卵巢组织对照组织中的 Ki67 和 CD34。通过实时聚合酶链反应测量 TK-1 信使 RNA 表达。
结果
恶性肿瘤（平均 4.85，范围 1.7-8.8）比良性肿瘤（1.65，范围 1.4-1.9）和正常卵巢对照组织（1.12，范围 0.6-1.5）的[18]FLT 摄取（SUV（max））更高。Ki67 染色确定的有丝分裂指数在恶性肿瘤中（18.89，范围 11.97-27.19）比良性肿瘤（0.59，范围 0.23-0.95）和对照组织（0.45，范围 0.06-1.20）更高。TK-1 表达在恶性肿瘤中也较高（35.52，范围 5.21-106.62）比良性肿瘤（8.71，范围 4.74-12.67）和对照组织（9.79，范围 0.85-39.46）。恶性组织中可见[18]FLT 摄取与 Ki67 有丝分裂指数之间呈递增趋势，而 CD34 染色在恶性、良性和对照组织之间则无明显差异。
结论
恶性组织中可见[18]FLT 摄取与 Ki67 有丝分裂指数之间呈递增趋势。进一步的研究将确定[18]FLT PET/CT 是否足够特异以区分癌性和非癌性细胞，并评估其在卵巢癌患者管理中的作用。
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