原发性肺癌摄取^(99)Tc^m-MIBI与耐多药蛋白表达的关系  

Correlation between uptake of ^(99)Tc^m-MIBI and expression of multidrug resistant protein in primary lung cancer

作　　者：薛建军[1] 杨爱民[1] 张芬茹[1] 王鸿雁[2] 邓元[2] 李积厚[1] 冯新利[1] 

机构地区：[1]西安交通大学第一医院核医学科,陕西西安710060 [2]西安交通大学第一医院病理科,陕西西安710060

出　　处：《中国医学影像技术》2006年第7期1090-1094,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨原发性肺癌99Tcm-MIBI显像与P-糖蛋白(P-gp)、多药耐药相关蛋白(MRP)表达的关系。方法对25例原发性肺癌患者行30min、180min99Tcm-MIBI断层显像,应用免疫组化法检测手术标本中P-gp、MRP表达水平;将早期摄取比值(EUR)、晚期摄取比值(DUR)及储留指数(RI)与P-gp、MRP表达进行对比研究。结果①99Tcm-MIBI早期显像阳性率为92.00%,延迟显像为80.00%,EUR为1.46±0.42,DUR为1.45±0.39,RI<0者13例,RI>0者12例。②P-gp、MRP表达阳性率分别为52.00%(13/25)、16.00%(8/25);③在P-gp表达阴性组、阳性组RI有显著性差异;P-gp表达与RI有相关性(P<0.001);EUR、DUR及RI在MRP表达阴性组、阳性组均未见显著性差异;三者与MRP表达均未见相关性。④以99Tcm-MIBI的RI<0作为肺癌耐药阳性阈值时,RI对P-gp的灵敏度、特异性分别为84.62%、83.33%,阳性预测值、阴性预测值也分别为:84.62%、83.33%。⑤P-gp表达在RI<0和RI>0组间分别为(0.327±0.041)、(0.267±0.036)(P<0.01),MRP表达在两组间未见显著性差异。结论99Tcm-MIBI显像的RI可以作为检测原发性肺癌P-gp表达的指标,是判断肺癌MDR的最佳参数。而99Tcm-MIBI显像与MRP表达的关系尚需验证。Objective To evaluate the relationship between the uptake of ^99Tc^m-MIBI and the expression of P-glycoprotein （P-gp） and multidrug resistance related protein （MRP） in primary lung cancer. Methods SPECT imaging was performed at 30 min and 180 min after injecting ^99Tc^m-MIBI in twenty-five patients with primary lung cancer. The uptake ratio of the lesion and the contralateral normal lung was obtained by early imaging （early uptake ratio, EUR） as well as delayed imaging （delayed uptake ratio, DUR） at the region of interest. The retention index （RI） was calculated as follows： RI= （DUR- EUR）/EUR. The ratio was compared with the level of P-gp and MRP expression detected by immunohistochemical analyses respectively. Results ① The positive rate of ^99Tc^m MIBI was 92.00% in early imaging and 80.00% in delayed imaging. The EUR and DUR of ^99Tc^m MIBI was （1.46±0.42） and （1.45±0.39） respectively. 13 cases were RI〈0, and 12 cases were RI〉0. ②The positive expressions of P-gp and MRP were observed in 13 （52.00%） cases and 4 （16.00%） cases respectively. ③There was significant difference in RI between P-gp（-） and P-gp（＋） and correlation between RI and P-gp levels. There was no significant difference between MRP （-） and MRP （＋） in those parameter, and no correlation between MRP levels and those parameter. ④When the RI〈0 of ^99 Tc^m MIBI was chosen as the positive threshold, the sensitive and specificity was 84.62% and 83.33% respectively, and the positive and negative predictive was 84.62% and 83.33%. ⑤There was significant difference between RI〈0 group and RI〈0 group in expression of P-gp, however, no difference in expression of MRP. Conclusion The RI of ^99Tc^m MIBI is the most useful parameter among EUR,DUR and RI for predicting MDR in primary lung cancer. The relationship between ^99 Tc^m-MIBI imaging and the expression of MRP should be validated by a larger series of study after following.

关 键 词：放射性核素显甲氧基异丁基异腈 肺肿瘤 多药耐药 P-糖蛋白 

分 类 号：R734.2[医药卫生—肿瘤]