Seifert J K, Görges R, Bockisch A, Junginger T
Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes-Gutenberg-Universität, Mainz, Germany.
Langenbecks Arch Chir. 1997;382(6):332-6.
The somatostatin analogue octreotide is effective in the treatment of neuroendocrine and other tumours. 111-In-labelled DTPA-octreotide scintigraphy is successful in localizing primary neuroendocrine tumours and metastases and other tumours containing somatostatin receptors. An antiproliferative effect of octreotide was also demonstrated for colorectal carcinoma. Since only about 40% of colorectal carcinomas express somatostatin receptors, we tried to establish whether 111-In-labelled DTPA-octreotide scintigraphy is able to reveal the receptor status of liver metastases in patients with colorectal liver metastases. This would be useful in selecting patients for adjuvant therapy studies with octreotide. We performed 111-In-labelled DTPA-octreotide scintigraphy in ten patients with nonresectable liver metasoffes of colorectal origin and curatively resected primary. In nine of ten patients the liver metastases were somatostatin receptor negative, in one patient somatostatin receptor positive. In the patient with somatostatin receptor-positive liver metastases after resection of a rectal carcinoma, the histological examination of the biopsies from the liver metastases showed a solid tumour of neuroendocrinal differentiation. In the repeated histological examination of the specimen of the rectal primary, a small solid tumour with neuroendocrinal differentiation was found between formations of adenocarcinoma (adenoendocrine carcinoma). In our study 111-In-labelled DTPA-octreotide scintigraphy did not indicate the receptor status of liver metastases from colorectal carcinoma and was not useful in the planning of therapeutic regimens. For the diagnosis of the receptor status of colorectal liver metastases autoradiographic investigation on tissue biopsies are still necessary. In patients with adenoendocrine carcinomas 111-In-labelled DTPA-octreotide scintigraphy may help to histologically differentiate the metastases.
生长抑素类似物奥曲肽在治疗神经内分泌肿瘤和其他肿瘤方面有效。¹¹¹铟标记的二乙三胺五乙酸 - 奥曲肽闪烁扫描术成功地定位了原发性神经内分泌肿瘤、转移灶以及其他含有生长抑素受体的肿瘤。奥曲肽对结直肠癌也显示出抗增殖作用。由于只有约40%的结直肠癌表达生长抑素受体，我们试图确定¹¹¹铟标记的二乙三胺五乙酸 - 奥曲肽闪烁扫描术是否能够揭示结直肠癌肝转移患者肝转移灶的受体状态。这对于选择接受奥曲肽辅助治疗研究的患者将是有用的。我们对10例患有不可切除的源自结直肠癌的肝转移灶且原发灶已根治性切除的患者进行了¹¹¹铟标记的二乙三胺五乙酸 - 奥曲肽闪烁扫描术。10例患者中有9例肝转移灶生长抑素受体阴性，1例生长抑素受体阳性。在1例直肠癌切除术后肝转移灶生长抑素受体阳性的患者中，对肝转移灶活检的组织学检查显示为神经内分泌分化的实体瘤。在对直肠原发灶标本的再次组织学检查中，在腺癌（腺内分泌癌）结构之间发现了一个具有神经内分泌分化的小实体瘤。在我们的研究中，¹¹¹铟标记的二乙三胺五乙酸 - 奥曲肽闪烁扫描术并未显示结直肠癌肝转移灶的受体状态，在治疗方案规划中也没有用处。对于结直肠癌肝转移灶受体状态的诊断，对组织活检进行放射自显影研究仍然是必要的。在腺内分泌癌患者中，¹¹¹铟标记的二乙三胺五乙酸 - 奥曲肽闪烁扫描术可能有助于对转移灶进行组织学鉴别。
