Division of General Thoracic Surgery, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2011 Jun;15(6):587-91.
A correct intra-operative detection of the tumour and, therefore, the complete surgical resection is critical to success in ACTH-secreting bronchial carcinoids. To date, all available preoperative and intra-operative procedures remain not entirely satisfactory. The use of intra-operative 111In-pentetreotide detection could offer a potentially reliable and rapid tool of real time assessment to achieve a radical resection.
In two cases of ACTH-secreting bronchial carcinoids, after a preliminary 111In-pentetreotide scan, radio-guided surgery was performed using a hand-held gamma probe 24 h after i.v. administration of the tracer.
The 111n-pentetreotide radioguided surgery with hand-held gamma probe, if compared with pre-operative 111In-pentetreotide, significantly improved the intra-operative surgical management by detecting a millimetric nodule in one case; detecting mediastinal lymph node metastasis in both cases and ruling out any other disease localization.
Intra-operative 111In-pentetreotide detection appears to be safe and easy to perform. This technique allowed to achieve a complete resection of all the tumor locations, that would have been impossible to detect with conventional surgical approach. On the basis of these results we advocate for a wider investigation of the potentialities connected with the radioguided surgery coupled with pre-operative 111In-pentetreotide scan as a promising procedure in the management of ACTH-secreting bronchial carcinoids.
在 ACTH 分泌性支气管类癌中，术中准确检测肿瘤并进行完整的外科切除是取得成功的关键。迄今为止，所有现有的术前和术中方法都不尽如人意。术中 111In-喷曲肽检测的应用可能为实时评估提供一种潜在可靠和快速的工具，从而实现根治性切除。
在 2 例 ACTH 分泌性支气管类癌患者中，在初步进行 111In-喷曲肽扫描后，在静脉注射示踪剂后 24 小时，使用手持式伽马探头进行放射性引导手术。
与术前 111In-喷曲肽相比，111n-喷曲肽放射性引导手术与手持式伽马探头联合使用，在术中手术管理方面有显著改善，在 1 例中检测到毫米级小结节；在 2 例中均检测到纵隔淋巴结转移，并排除了其他任何疾病定位。
术中 111In-喷曲肽检测似乎是安全且易于进行的。该技术可实现所有肿瘤部位的完全切除，而这在传统手术方法下是不可能实现的。基于这些结果，我们主张更广泛地研究与术前 111In-喷曲肽扫描相结合的放射性引导手术的潜力，作为 ACTH 分泌性支气管类癌治疗的一种有前途的方法。
