Sipka Gábor, Farkas István, Bakos Annamária, Maráz Anikó, Mikó Zsófia Sára, Czékus Tamás, Bukva Mátyás, Urbán Szabolcs, Pávics László, Besenyi Zsuzsanna
Department of Nuclear Medicine, University of Szeged, 6720 Szeged, Hungary.
Department of Oncotherapy, University of Szeged, 6720 Szeged, Hungary.
Cancers (Basel). 2025 Sep 8;17(17):2935. doi: 10.3390/cancers17172935.
Neuroendocrine neoplasms (NENs) are a diverse group of malignancies in which somatostatin receptor expression can be crucial in guiding therapy. We aimed to evaluate the effectiveness of [Tc]Tc-EDDA/HYNIC-TOC SPECT/CT in differentiating neuroendocrine tumor histology, selecting candidates for radioligand therapy, and identifying correlations between somatostatin receptor expression and non-imaging parameters in metastatic NENs. This retrospective study included 65 patients (29 women, 36 men, mean age 61) with metastatic neuroendocrine neoplasms confirmed by histology, follow-up, or imaging, comprising 14 poorly differentiated carcinomas and 51 well-differentiated tumors. Somatostatin receptor SPECT/CT results were assessed visually and semiquantitatively, with mathematical models incorporating histological, oncological, immunohistochemical, and laboratory parameters, followed by biostatistical analysis. Of 392 lesions evaluated, the majority were metastases in the liver, lymph nodes, and bones. Mathematical models estimated somatostatin receptor expression accurately (70-83%) based on clinical parameters alone. Key factors included tumor origin, oncological treatments, and the immunohistochemical marker CK7. Associations were found between age, grade, disease extent, and markers (CEA, CA19-9, AFP). Our findings suggest that [Tc]Tc-EDDA/HYNIC-TOC SPECT/CT effectively evaluates somatostatin receptor expression in NENs. Certain immunohistochemical and laboratory parameters, beyond recognized factors, show potential prognostic value, supporting individualized treatment strategies.
神经内分泌肿瘤（NENs）是一组多样的恶性肿瘤，其中生长抑素受体表达对指导治疗可能至关重要。我们旨在评估[锝]Tc-EDDA/HYNIC-TOC SPECT/CT在鉴别神经内分泌肿瘤组织学、选择放射性配体治疗候选者以及确定转移性NENs中生长抑素受体表达与非影像学参数之间相关性方面的有效性。这项回顾性研究纳入了65例患者（29例女性，36例男性，平均年龄61岁），这些患者经组织学、随访或影像学证实患有转移性神经内分泌肿瘤，包括14例低分化癌和51例高分化肿瘤。对生长抑素受体SPECT/CT结果进行了视觉和半定量评估，采用了纳入组织学、肿瘤学、免疫组织化学和实验室参数的数学模型，随后进行生物统计学分析。在评估的392个病灶中，大多数为肝脏、淋巴结和骨骼的转移灶。数学模型仅基于临床参数就能准确估计生长抑素受体表达（70%-83%）。关键因素包括肿瘤起源、肿瘤治疗以及免疫组织化学标志物CK7。发现年龄、分级、疾病范围和标志物（癌胚抗原、CA19-9、甲胎蛋白）之间存在关联。我们的研究结果表明，[锝]Tc-EDDA/HYNIC-TOC SPECT/CT能有效评估NENs中的生长抑素受体表达。某些免疫组织化学和实验室参数，除了已公认的因素外，显示出潜在的预后价值，支持个体化治疗策略。
