1 Pulmonary Department, Oncology Unit, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Macedonia, Greece.
2 Nuclear Medicine Department, Anticancer Hospital Theagenio, Thessaloniki, Macedonia, Greece.
Technol Cancer Res Treat. 2019 Jan 1;18:1533033819842586. doi: 10.1177/1533033819842586.
Νeuroendocrine tumors of the lungs are rare arising in the thymus and gastro-entero-pancreatic tract and belonging to foregut of neuroendocrine tumors. The aim of the present prospective study was to estimate the potential impact of single-photon emission computed tomography somatostatin receptor scintigraphy using 99mTc-Tektrotyd on diagnosis, treatment response, and prognosis in patients with neuroendocrine tumors of the lungs.
Thirty-six patients with neuroendocrine tumors of the lungs were evaluated by using 99mTc-HYNIC-TOC scintigraphy. The scintigraphic results were compared to liver tissue uptake (Krenning score). Likewise, the functional imaging results were compared with biochemical indices including chromogranin A, neuroendocrine-specific enolase, and insulin-like growth factor 1 at the time of diagnosis (baseline) and disease progression.
The number of somatostatin receptors, expressed with Krenning score, did not show any correlation with the survival of patients both at baseline ( P = .08) and at disease progression ( P = .24), and scintigraphy results did not relate significantly to progression-free survival. Comparing the results of 99mTc-HYNIC-TOC scintigraphy according to the response of patients in the initial treatment, a statistically significant negative correlation was observed both in the first and in the second scintigraphy with patients' response ( P = .001 and P < .001, respectively). The concentrations of biochemical markers were in accordance with scintigraphy results in the diagnosis.
This study indicates that 99mTc-HYNIC-TOC scintigraphy appears to be a reliable, noninvasive technique for detection of primary neuroendocrine tumors and their locoregional or distant metastases, although it cannot be used as a neuroendocrine tumors of the lungs predictive technique.
肺神经内分泌肿瘤起源于胸腺和胃肠胰，属于前肠神经内分泌肿瘤，较为罕见。本前瞻性研究旨在评估 99mTc-Tektrotyd 标记的生长抑素受体单光子发射计算机断层扫描（SRS）对肺神经内分泌肿瘤患者的诊断、治疗反应和预后的潜在影响。
对 36 例肺神经内分泌肿瘤患者进行 99mTc-HYNIC-TOC 闪烁显像。将闪烁显像结果与肝组织摄取（Krenning 评分）进行比较。同样，在诊断时（基线）和疾病进展时，将功能成像结果与包括嗜铬粒蛋白 A、神经内分泌特异性烯醇化酶和胰岛素样生长因子 1 在内的生化指标进行比较。
Krenning 评分表示的生长抑素受体数量与患者的生存均无相关性，无论是在基线（P=0.08）还是在疾病进展时（P=0.24），且闪烁显像结果与无进展生存期无显著相关性。根据患者初始治疗的反应比较 99mTc-HYNIC-TOC 闪烁显像的结果，在第一次和第二次闪烁显像中均观察到与患者反应呈统计学显著负相关（P=0.001 和 P<0.001）。生化标志物的浓度与诊断时的闪烁显像结果一致。
本研究表明，99mTc-HYNIC-TOC 闪烁显像似乎是一种可靠的、非侵入性技术，可用于检测原发性神经内分泌肿瘤及其局部或远处转移，尽管它不能作为预测肺神经内分泌肿瘤的技术。
