Institute of Nuclear Medicine, University College Hospital, London, United Kingdom.
J Nucl Med. 2011 Jul;52(7):1073-8. doi: 10.2967/jnumed.110.085142. Epub 2011 Jun 16.
Glucagon-like peptide-1 (GLP-1) receptor imaging is superior to somatostatin receptor subtype 2 (sst(2)) imaging in localizing benign insulinomas. Here, the role of GLP-1 and sst(2) receptor imaging in the management of malignant insulinoma patients was investigated.
Eleven patients with malignant insulinoma were prospectively included. (111)In-[Lys(40)(Ahx-diethylenetriaminepentaacetic acid [DTPA])NH(2)]-exendin-4 SPECT/CT, (68)Ga- DOTATATE PET/CT, and in vitro receptor autoradiography were performed to assess the receptor status and to evaluate the detection rate.
GLP-1 receptor targeting was positive in 4 of 11 patients, and sst(2) receptor expression was positive in 8 of 11. In only 1 patient were both receptors expressed. In 1 patient, GLP-1 receptor imaging was the only method that successfully localized the primary tumor in the pancreas. In 3 patients with sst(2)-expressing tumors, DOTATATE radiotherapy was effectively applied.
As opposed to benign insulinomas, malignant insulinomas often lack GLP-1 receptors. Conversely, malignant insulinomas often express sst(2), which can be targeted therapeutically.
研究胰高血糖素样肽-1（GLP-1）受体和生长抑素受体 2（sst（2））受体成像在恶性胰岛素瘤患者管理中的作用。
前瞻性纳入 11 例恶性胰岛素瘤患者。采用（111）In-[Lys（40）（Ahx-二乙三胺五乙酸[DTPA]）NH2] -exendin-4 SPECT/CT、（68）Ga-DOTATATE PET/CT 和体外受体 Autoradiography 评估受体状态并检测率。
11 例患者中，4 例 GLP-1 受体阳性，8 例 sst（2）受体阳性，仅 1 例两者均阳性。GLP-1 受体成像仅在 1 例患者中成功定位胰腺原发肿瘤。在 3 例表达 sst（2）的肿瘤患者中，DOTATATE 放疗有效。
与良性胰岛素瘤相反，恶性胰岛素瘤通常缺乏 GLP-1 受体。相反，恶性胰岛素瘤通常表达 sst（2），可以进行靶向治疗。
