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新型靶向纳米颗粒造影剂联合增强CT在早期胃癌筛查中的应用

Application of novel targeting nanoparticles contrast agent combined with contrast-enhanced computed tomography during screening for early-phase gastric carcinoma.

作者信息

Zhang Kaimin, Du Xijian, Yu Kaihu, Zhang Kaiyu, Zhou Yicheng

机构信息

Physical Examination Center, Xianning Central Hospital, Xianning, Hubei 437000, P.R. China.

Department of Radiology, Xianning Central Hospital, Xianning, Hubei 437000, P.R. China.

出版信息

Exp Ther Med. 2018 Jan;15(1):47-54. doi: 10.3892/etm.2017.5388. Epub 2017 Oct 30.

Abstract

Gastric cancer is one of the most common human tumors worldwide. The biggest bottleneck is a lack of advanced and sensitive protocols for the diagnosis of patients with early-stage gastric cancer. Therefore, more sensitive methods of diagnosing gastric cancer are urgently required to improve survival rates. In this clinical study, contrast-enhanced computed tomography (CECT) with targeting nanoparticles contrast agent (CECT-TNCA) was used to diagnose early-stage gastric cancer. The specific-targeted tyrosine kinase inhibitors of gastric cancer, including platelet-derived growth factor receptor-β, Ret and Kit, were used as TNCAs. A total of 484 patients with suspected gastric cancer were voluntarily recruited to investigate the efficacy of CECT-TNCA in the diagnosis of patients with early-stage gastric cancer. Patients with suspected gastric cancer were subjected CT and CECT-TNCA to detect whether gastric tumors existed. TNCA was orally administered before CT and CECT-TNCA (20 min). Our diagnostic data revealed that CECT-TNCA improved sensitivity and provided a new protocol to diagnose tumors in patients with suspected gastric cancer at the early stage. In addition, imaging using CECT-TNCA enabled the visualization of tiny nodules in the gastric area. CECT-TNCA diagnosed 182 patients with suspected gastric cancer as tumor-free. CECT-TNCA confirmed gastric cancer in 302 patients. Our novel diagnosis indicated significantly (P<0.01) differential signal enhancement in the gastric nodules via CECT-TNCA compared with CT, suggesting higher accuracy and the accumulation of TNCA in tumor nodules in the stomach. Furthermore, survival rates of patients detected by early-diagnosis of CECT-TNCA were significantly higher than the mean five-year survival (P<0.01). In conclusion, our investigations demonstrate that the sensibility and accuracy of CT is improved through combination with liposome-encapsulated nanoparticle contrast agent for the diagnosis of early stage gastric cancer when compared with single CT detection. CECT-TNCA improves the accuracy of CT and diagnostic confidence in assessing mural enhancement in patients with suspected gastric cancer.

摘要

胃癌是全球最常见的人类肿瘤之一。最大的瓶颈是缺乏用于诊断早期胃癌患者的先进且灵敏的方案。因此,迫切需要更灵敏的胃癌诊断方法来提高生存率。在这项临床研究中,使用靶向纳米颗粒造影剂的对比增强计算机断层扫描(CECT-TNCA)来诊断早期胃癌。胃癌的特异性靶向酪氨酸激酶抑制剂,包括血小板衍生生长因子受体-β、Ret和Kit,被用作TNCA。总共自愿招募了484例疑似胃癌患者,以研究CECT-TNCA在诊断早期胃癌患者中的疗效。对疑似胃癌患者进行CT和CECT-TNCA检查,以检测是否存在胃肿瘤。在CT和CECT-TNCA检查前20分钟口服TNCA。我们的诊断数据显示,CECT-TNCA提高了敏感性,并为诊断早期疑似胃癌患者的肿瘤提供了一种新方案。此外,使用CECT-TNCA成像能够可视化胃区域的微小结节。CECT-TNCA诊断出182例疑似胃癌患者无肿瘤。CECT-TNCA确诊302例患者患有胃癌。我们的新诊断表明,与CT相比,通过CECT-TNCA在胃结节中显著(P<0.01)有差异信号增强,表明更高的准确性以及TNCA在胃肿瘤结节中的积聚。此外,通过CECT-TNCA早期诊断的患者生存率显著高于平均五年生存率(P<0.01)。总之,我们的研究表明,与单次CT检测相比,通过与脂质体包裹的纳米颗粒造影剂联合使用,CT在诊断早期胃癌时的敏感性和准确性得到了提高。CECT-TNCA提高了CT的准确性以及对疑似胃癌患者壁增强评估的诊断信心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e53c/5769276/6956a89f1b80/etm-15-01-0047-g00.jpg

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