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[中枢神经细胞瘤中葡萄糖代谢的动力学]

[Kinetics of glucose metabolism in central neurocytomas].

作者信息

Shioya H, Mineura K, Sasajima T, Kowada M, Iida H, Ogawa T, Hatazawa J, Uemura K

机构信息

Neurosurgical Service, Akita University Hospital, Japan.

出版信息

No To Shinkei. 1995 Oct;47(10):981-7.

PMID:7577144
Abstract

To estimate proliferating activity of central neurocytoma, we measured kinetic rate constants and glucose metabolic rate (kinetic-rCMRGI) using dynamic positron emission tomography (PET), as well as autoradiographic rCMRG1 (arg-rCMRG1), in patients with histologically verified central neurocytoma. The subject included five patients, four males and one female, aged from 23 to 53 years with a mean age of 41 years old. All tumors were located in the lateral ventricle and two extended into the third ventricle through the forearm of Monro. Tumor lesion on the PET images was determined using CT or MRI, which was performed at levels equivalent to those for the PET scans. The kinetic rate constants of tracer transport from blood to brain (k1), reverse transport from brain to blood (k2), and phosphorylation (k3) were analyzed according to the three compartment 18F-fluorodeoxyglucose (FDG) model. For quantitative analysis, regions of interest (ROI) on PET images were delineated on the tumor and the contralateral gray matter. Tumor k1 and k2 values were similar to or higher than those of the contralateral gray matter, suggesting high permeability due to lack of blood-brain barrier. Tumor k3 value, an indicator of hexokinase activity, and kinetic-rCMRG1 were exceedingly lower in three of five patients. These three patients have been free from tumor recurrence or regrowth, postoperatively. The other two patients, tumor kinetic-rCMRG1 was similar to or higher than that of the contralateral gray matter. One patient suffered from tumor regrowth shortly after resection, and the other has been followed up postoperatively. Thus, k3 and kinetic-rCMRG1 are indicative parameters of proliferative activity in central neurocytoma.

摘要

为评估中枢神经细胞瘤的增殖活性,我们使用动态正电子发射断层扫描(PET)测量了动力学速率常数和葡萄糖代谢率(动力学-rCMRGl),并对经组织学证实的中枢神经细胞瘤患者进行了放射自显影rCMRG1(arg-rCMRG1)检测。研究对象包括5例患者,4例男性和1例女性,年龄在23至53岁之间,平均年龄为41岁。所有肿瘤均位于侧脑室,其中2例通过Monro孔延伸至第三脑室。PET图像上的肿瘤病变通过CT或MRI确定,其扫描层面与PET扫描层面相同。根据三室18F-氟脱氧葡萄糖(FDG)模型分析示踪剂从血液到脑的转运动力学速率常数(k1)、从脑到血液的逆向转运(k2)以及磷酸化(k3)。为进行定量分析,在PET图像上于肿瘤及对侧灰质划定感兴趣区(ROI)。肿瘤的k1和k2值与对侧灰质相似或更高,提示因血脑屏障缺失而具有高通透性。在5例患者中有3例,肿瘤的k3值(己糖激酶活性指标)及动力学-rCMRGl极低。这3例患者术后无肿瘤复发或再生长。另外2例患者,肿瘤的动力学-rCMRGl与对侧灰质相似或更高。1例患者术后不久出现肿瘤再生长,另1例患者术后一直在接受随访。因此,k3和动力学-rCMRGl是中枢神经细胞瘤增殖活性的指示参数。

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