Kälkner K M, Ginman C, Nilsson S, Bergström M, Antoni G, Ahlström H, Långström B, Westlin J E
Department of Oncology, University Hospital, Uppsala University, Sweden.
Nucl Med Biol. 1997 May;24(4):319-25. doi: 10.1016/s0969-8051(97)00064-4.
The discovery of neuroendocrine differentiation in hormone-refractory prostatic adenocarcinoma has opened a potentially new therapeutic approach in this group of patients with a poor prognosis and few effective therapy modalities. Based on previous findings of increased uptake of 11C-5-hydroxytryptophan (11C-5-HTP) in neuroendocrine tumours using the PET technique, this tracer was applied in the study of 10 patients with metastatic hormone-refractory prostatic adenocarcinoma. In three patients, the study was repeated after treatment. An increased uptake of 11C-5-HTP was observed in all investigated skeletal lesions, although the magnitude of the uptake was moderate. The difference between the standard uptake values (SUV) in normal bone and metastatic lesions was significant (p < 0.001). A kinetic analysis of the uptake of 11C-5-HTP demonstrates an increase during the first minutes followed by a wash-out and a stabilization of the tissue/blood ratio at about 2. The Patlak plots demonstrated a gradual increase in the transport rate during the first 20 to 30 min, after which a constant level was observed. The SUV varied between patients and between lesions over time and treatment. The uptake of 11C-5-HTP discriminates metastatic lesions from normal bone and may thus aid in the diagnosis and, potentially, in treatment monitoring of metastatic hormone-refractory prostatic adenocarcinoma. Uptake kinetics are characterized by a wash-out and cannot alone be used as proof of neuroendocrine differentiation in hormone-refractory prostatic adenocarcinoma.
在激素难治性前列腺腺癌中发现神经内分泌分化，为这组预后较差且有效治疗方式有限的患者开辟了一种潜在的新治疗方法。基于先前利用正电子发射断层扫描（PET）技术发现神经内分泌肿瘤对11C - 5 - 羟色氨酸（11C - 5 - HTP）摄取增加的研究结果，该示踪剂被应用于10例转移性激素难治性前列腺腺癌患者的研究中。3例患者在治疗后重复进行了该研究。在所有被调查的骨骼病变中均观察到11C - 5 - HTP摄取增加，尽管摄取程度为中等。正常骨与转移灶的标准摄取值（SUV）之间的差异具有统计学意义（p < 0.001）。对11C - 5 - HTP摄取的动力学分析表明，在最初几分钟内摄取增加，随后出现洗脱，组织/血液比值在约2时趋于稳定。Patlak图显示在最初20至30分钟内转运速率逐渐增加，之后观察到恒定水平。SUV在患者之间以及随时间和治疗的不同病变之间存在差异。11C - 5 - HTP的摄取可区分转移灶与正常骨，因此可能有助于转移性激素难治性前列腺腺癌的诊断以及潜在的治疗监测。摄取动力学的特征是洗脱，不能单独作为激素难治性前列腺腺癌中神经内分泌分化的证据。
