Cremonini N, Furno A, Sforza A, Chiarini V, Graziano E, Zampa G, Turba E
Department of Endocrinology and Metabolic Diseases, Ospedale Maggiore, Bologna, Italy.
Q J Nucl Med. 1995 Dec;39(4 Suppl 1):116-20.
A large number of endocrine tumors express somatostatin receptors, and the use of radiolabeled somatostatin analogs has been recently introduced for their localization. Using in vivo scintigraphy with 111In-pentetreotide, primary tumor localizations were demonstrated in 3/3 carcinoids (2 intestinal carcinoids and 1 lung ACTH-secreting carcinoid; in 2 patients liver metastases larger than 1 cm were visualized), in 1/1 GH-secreting pituitary macroadenoma, and in 1/1 thyroid localization of MTC. Bone and/or lymph node metastases were imaged in 2/4 patients previously treated for MTC, with persistently high CT and CEA levels; in the other 2 patients the other scintigraphic techniques were also negative. Octreotide scintigraphy was negative in 2/2 insulinomas and in 2/2 ACT-producing pituitary adenomas. In 2 patients with carcinoid syndrome and 1 patient with Cushing syndrome due to ectopic ACTH, octreotide therapy induced a significant decrease in tumoral markers. Our preliminary data are in agreement with the results of larger series reported in literature: octreotide scintigraphy is a useful noninvasive tool to detect endocrine tumors expressing somatostatin receptors, particularly for carcinoids. It is of great use in the differential diagnosis of Cushing syndrome due to ectopic ACTH. Moreover, 111In-pentetreotide scintigraphy may be useful in selecting patients who may benefit from octreotide therapy to control hormonal hypersecretion effects.
大量内分泌肿瘤表达生长抑素受体，近来已引入放射性标记的生长抑素类似物用于其定位。使用铟-111喷曲肽进行体内闪烁扫描，在3例类癌（2例肠道类癌和1例分泌促肾上腺皮质激素的肺类癌；2例患者中可见大于1 cm的肝转移灶）、1例分泌生长激素的垂体大腺瘤以及1例甲状腺髓样癌中均显示出原发性肿瘤定位。2例先前接受过甲状腺髓样癌治疗且降钙素和癌胚抗原水平持续升高的患者中，骨和/或淋巴结转移灶显影；另外2例患者其他闪烁扫描技术结果也为阴性。奥曲肽闪烁扫描在2例胰岛素瘤和2例分泌促肾上腺皮质激素的垂体腺瘤中均为阴性。在2例类癌综合征患者和1例因异位促肾上腺皮质激素导致库欣综合征的患者中，奥曲肽治疗使肿瘤标志物显著降低。我们的初步数据与文献报道的更大系列研究结果一致：奥曲肽闪烁扫描是检测表达生长抑素受体的内分泌肿瘤的一种有用的非侵入性工具，尤其对于类癌。它在因异位促肾上腺皮质激素导致的库欣综合征的鉴别诊断中非常有用。此外，铟-111喷曲肽闪烁扫描在选择可能从奥曲肽治疗中受益以控制激素分泌过多效应的患者方面可能有用。
