Herlin Gunnar, Ideström Lars, Lundell Lars, Aspelin Peter, Axelsson Rimma
Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, 141 86 Stockholm, Sweden.
Int J Mol Imaging. 2011;2011:279345. doi: 10.1155/2011/279345. Epub 2011 May 17.
Background. While the surface of a cell normally has some amount of somatostatin receptors, these receptors are overexpressed to a very high degree in multiple neoplastic diseases. No data exist for esophageal carcinoma. Purpose. To find out whether esophageal carcinoma could be imaged using somatostatin receptor scintigraphy. Material and Methods. 34 patients with esophageal lesions were prospectively examined by (99m)Tc-depreotide scintigraphy 2 and 4 hours after injection. Quantitative evaluation of (99m)Tc-depreotide uptake was performed around the lesion (T) and in healthy lung parenchyma (B). The relative uptake was calculated as T-B/B. Scintigraphy results were compared with histopathology from surgery or biopsy specimens from endoscopic ultrasonography. Results. 21 patients had esophageal cancer, and 13 lesions were benign. Visual assessment revealed positive (99m)Tc-depreotide uptake in 16 of the 21 cancers. The 13 patients without cancer had no depreotide uptake. The Mann-Whitney U test showed a statistically significant difference (P < .005) between (99m)Tc-depreotide uptake in malignant and benign lesions, for both the 2-hour and the 4-hour measurements. Conclusion. Scintigraphic examination with (99m)Tc-depreotide is feasible for imaging esophageal cancer, but the method is not suitable neither for screening or primary diagnosis, because of methods modest sensitivity. Our first results showed high specificity which should be used with caution, as the number of patients was relatively low. Further studies are needed to determine the role of the method.
背景。虽然细胞表面通常有一定数量的生长抑素受体，但这些受体在多种肿瘤疾病中会过度表达至很高程度。目前尚无关于食管癌的相关数据。目的。探究食管癌是否可用生长抑素受体闪烁显像进行成像。材料与方法。对34例食管病变患者在注射后2小时和4小时进行前瞻性（99m）锝-德普奥肽闪烁显像检查。在病变周围（T）和健康肺实质（B）对（99m）锝-德普奥肽摄取进行定量评估。相对摄取量计算为（T - B）/B。将闪烁显像结果与手术组织病理学或内镜超声活检标本的组织病理学结果进行比较。结果。21例患者患有食管癌，13个病变为良性。视觉评估显示，21例癌症中有16例（99m）锝-德普奥肽摄取呈阳性。13例无癌症的患者无德普奥肽摄取。Mann-Whitney U检验显示，在2小时和4小时测量时，恶性和良性病变的（99m）锝-德普奥肽摄取之间存在统计学显著差异（P <.005）。结论。（99m）锝-德普奥肽闪烁显像检查对食管癌成像可行，但由于该方法敏感性一般，不适用于筛查或初步诊断。我们的初步结果显示特异性较高，但由于患者数量相对较少，应谨慎使用。需要进一步研究以确定该方法的作用。
