[I]-血管内皮生长因子 ([I]-VEGF) 在神经胶质瘤中的预后价值。
The prognostic value of [I]-vascular endothelial growth factor ([I]-VEGF) in glioma.
机构信息
Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
Department of Nuclear Medicine, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Science and PUMC, Beijing, China.
出版信息
Eur J Nucl Med Mol Imaging. 2018 Dec;45(13):2396-2403. doi: 10.1007/s00259-018-4088-y. Epub 2018 Jul 30.
PURPOSE
Recent studies have shown that tumor vascular endothelial cells and various tumor cells overexpress receptors for vascular endothelial growth factor (VEGF). The aim of this study was to investigate the prognostic value of [I]-VEGF scintigraphy in patients with histologically verified brain tumors.
METHODS
23 consecutive patients (9 women and 14 men aged 30-83 years, mean age 56.6 ± 14.4 years) with histopathologically-verified primary brain tumors were included in the study. All patients had undergone [I]-VEGF scintigraphy. SPECT examinations of brain were performed 30 min and 18 h after injection. Additional [C]-methionine PET ([C]-MET PET) was performed in eight of the 23 patients. Both [I]-VEGF and [C]-MET PET were evaluated visually and semiquantitatively by tumor-to-normal brain uptake ratio (T/N ratio). Thresholds of the T/N ratio were evaluated by analysis of receiver operating characteristics (ROC). Overall survival (OS) was estimated using the Kaplan-Meier method.
RESULTS
World Health Organization (WHO) grade IV glioma lesions showed [I]-VEGF uptake 18 h after the injection, whereas other brain tumors of grade II or III showed negative results. There was no significant difference in the tumor size between VEGF positive and VEGF negative tumors. Patients with [I]-VEGF T/N ratio threshold <1.32 showed significantly longer survival than patients with T/N ratio ≥ 1.32 (2680 days vs 295 days; P < 0.05). In the subgroup of 16 grade IV glioma patients, significant OS differences were found using a T/N ratio of 1.75 as threshold (T/N ratio < 1.75: 720 days; T/N ≥ 1.75: 183 days; P < 0.05). Significant difference (P < 0.05) was also found in [C]-MET PET T/N ratios between the grade IV glioma (mean T/N ratio: 3.71) and the grade II or III glioma (mean T/N ratio: 1.74).
CONCLUSION
Our results suggest that [I]-VEGF scintigraphy may be useful for visualization of tumor angiogenesis. In addition, [I]-VEGF may provide relevant prognostic information in patients with glioma.
目的
最近的研究表明，肿瘤血管内皮细胞和各种肿瘤细胞过度表达血管内皮生长因子（VEGF）受体。本研究旨在探讨组织学证实的脑肿瘤患者[I]-VEGF 闪烁显像的预后价值。
方法
本研究纳入了 23 例连续患者（9 名女性和 14 名男性，年龄 30-83 岁，平均年龄 56.6±14.4 岁），这些患者均经组织病理学证实为原发性脑肿瘤。所有患者均接受了[I]-VEGF 闪烁显像。注射后 30 分钟和 18 小时进行 SPECT 脑检查。在 23 例患者中的 8 例中还进行了[C]-蛋氨酸 PET（[C]-MET PET）。通过肿瘤与正常脑摄取比（T/N 比），对[I]-VEGF 和[C]-MET PET 进行视觉和半定量评估。通过接收者操作特征（ROC）分析评估 T/N 比的阈值。使用 Kaplan-Meier 方法估计总生存期（OS）。
结果
世界卫生组织（WHO）IV 级胶质瘤病变在注射后 18 小时显示出[I]-VEGF 摄取，而 II 级或 III 级的其他脑肿瘤则显示为阴性结果。VEGF 阳性和 VEGF 阴性肿瘤之间的肿瘤大小无显著差异。[I]-VEGF T/N 比阈值<1.32 的患者的生存时间明显长于 T/N 比≥1.32 的患者（2680 天比 295 天；P<0.05）。在 16 例 IV 级胶质瘤患者的亚组中，当使用 1.75 作为阈值时，发现 OS 存在显著差异（T/N 比<1.75：720 天；T/N≥1.75：183 天；P<0.05）。IV 级胶质瘤（平均 T/N 比：3.71）和 II 级或 III 级胶质瘤（平均 T/N 比：1.74）之间的[C]-MET PET T/N 比也存在显著差异（P<0.05）。
结论
我们的结果表明，[I]-VEGF 闪烁显像可能有助于肿瘤血管生成的可视化。此外，[I]-VEGF 可能为胶质瘤患者提供相关的预后信息。
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