Departments of *Pharmacology, †Obstetrics and Gynecology, ‡Pathology, Rush University Medical Center, Chicago; and §Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana-Champaign; and ∥Department of Preventive Medicine (Biostatistics), Rush University Medical Center, Chicago, IL.
Int J Gynecol Cancer. 2014 Jan;24(1):19-28. doi: 10.1097/IGC.0000000000000040.
Because of the lack of an effective early detection test, ovarian cancer (OVCA) in most cases is detected at late stages and remains a fatal gynecological malignancy. Molecular imaging provides information on the changes associated with the development of a disease at molecular levels. Because angiogenesis is an early event in tumor development, increased expression of αvβ3 integrins by ovarian tumor-associated angiogenic microvessels provides a target for noninvasive ultrasound imaging to detect early-stage OVCA. The goal of this study was to examine the feasibility of αvβ3 integrin-targeted molecular imaging agent in enhancing the detection of spontaneous ovarian tumor in laying hens, a preclinical model of OVCA.
The study was conducted in 2 phases, including a cross-sectional exploratory followed by a prospective monitoring of hens for 45 weeks with targeted ultrasound imaging. Changes in ultrasound signal intensity were determined before and after the injection of αvβ3 integrin-targeted imaging agent in hens with spontaneous OVCA. All images were digitally stored. After scanning, ovarian tissues from all hens were collected and processed for histopathologic and immunohistochemical studies.
Ultrasound signal intensity was significantly (P < 0.001) higher in hens with early-stage OVCA than in normal hens and increased further in late-stage OVCA. Compared with that in normal cases, ultrasound signal intensities increased approximately 19-fold in early stage and 26-fold in late-stage OVCA. Differences in signal enhancement were not observed among different histologic subtypes of OVCA. Higher signal intensities from targeted imaging of ovarian tumors were associated with increased number of αvβ3 integrin-expressing ovarian microvessels. Prospective monitoring of hens with αvβ3 integrin-targeted imaging agent detected OVCA at early stage.
These results suggest that αvβ3 integrin-targeted imaging agent enhanced the visualization of ovarian tumor-associated angiogenic microvessels in hens with early-stage OVCA and may form a foundation for clinical studies.
由于缺乏有效的早期检测试验,大多数情况下卵巢癌(OVCA)在晚期才被发现,仍然是一种致命的妇科恶性肿瘤。分子成像提供了与疾病在分子水平上发展相关的变化信息。由于血管生成是肿瘤发展的早期事件,卵巢肿瘤相关血管生成微血管中 αvβ3 整联蛋白的过度表达为非侵入性超声成像提供了检测早期 OVCA 的靶点。本研究的目的是研究靶向 αvβ3 整联蛋白的分子成像剂在增强对 laying hens(OVCA 的临床前模型)自发性卵巢肿瘤检测中的可行性。
研究分为两个阶段进行,包括横断面探索性研究,然后对 45 周的母鸡进行靶向超声成像的前瞻性监测。在有自发性 OVCA 的母鸡中注射靶向 αvβ3 整联蛋白的成像剂前后,确定超声信号强度的变化。所有图像均以数字形式存储。扫描后,收集所有母鸡的卵巢组织并进行组织病理学和免疫组织化学研究。
与正常母鸡相比,早期 OVCA 母鸡的超声信号强度显著升高(P < 0.001),晚期 OVCA 进一步升高。与正常病例相比,早期 OVCA 中超声信号强度增加了约 19 倍,晚期 OVCA 中增加了约 26 倍。OVCA 的不同组织学亚型之间未观察到信号增强的差异。卵巢肿瘤靶向成像的信号强度增加与表达 αvβ3 整联蛋白的卵巢微血管数量增加相关。用靶向 αvβ3 整联蛋白成像剂对母鸡进行前瞻性监测可在早期检测到 OVCA。
这些结果表明,靶向 αvβ3 整联蛋白的成像剂增强了对 hens 早期 OVCA 中卵巢肿瘤相关血管生成微血管的可视化,并可能为临床研究奠定基础。