Tisell L E, Ahlman H, Wängberg B, Hansson G, Mölne J, Nilsson O, Lindstedt G, Fjälling M, Forssell-Aronsson E
Department of Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Br J Surg. 1997 Apr;84(4):543-7.
111In-radiolabelled (DTPA-D-Phe1)-octreotide scintigraphy can be used to localize neuroendocrine tumours expressing somatostatin receptors (SSTRs). The aim of this paper was to analyse the importance of tumour volume and growth for the visualization by SSTR scintigraphy of metastases from medullary thyroid carcinoma (MTC).
Serum calcitonin concentrations were used to estimate volume and growth rate of MTC. Twenty-two patients who had persistent hypercalcitoninaemia after total thyroidectomy for MTC, indicating the presence of metastases, were studied.
SSTR scintigraphy visualized 15 tumours in 11 patients. Patients with scintigraphically visualized tumours had higher serum calcitonin and carcinoembryonic antigen concentrations and larger tumours, and the serum calcitonin concentration increased more rapidly with time. Tumour-associated symptoms and death from MTC occurred only in patients with scintigraphically visualized tumours.
Scintigraphically visualized tumours grow more rapidly and are more aggressive than nonvisualized lesions. SSTR scintigraphy can be helpful in the planning of palliative surgery for MTC and for diagnosing distant metastases, but cannot localize microscopic metastases.
铟-111标记的（二乙烯三胺五乙酸-D-苯丙氨酸1）-奥曲肽闪烁扫描可用于定位表达生长抑素受体（SSTRs）的神经内分泌肿瘤。本文旨在分析肿瘤体积和生长对甲状腺髓样癌（MTC）转移灶SSTR闪烁扫描可视化的重要性。
血清降钙素浓度用于评估MTC的体积和生长速率。研究了22例因MTC行甲状腺全切除术后仍存在高降钙素血症（提示存在转移）的患者。
SSTR闪烁扫描在11例患者中发现了15个肿瘤。闪烁扫描发现肿瘤的患者血清降钙素和癌胚抗原浓度更高，肿瘤更大，且血清降钙素浓度随时间升高更快。MTC相关症状和死亡仅发生在闪烁扫描发现肿瘤的患者中。
闪烁扫描发现的肿瘤比未发现的病灶生长更快、侵袭性更强。SSTR闪烁扫描有助于MTC姑息手术的规划和远处转移的诊断，但不能定位微小转移灶。
