非小细胞肺癌~99Tc^m-HL91显像与恶性程度、HIF-1α表达的相关性  

The correlation of ~99Tc^m-HL91 imaging with malignancy grading,HIF-1α expression in NSCLC

作　　者：武新宇[1] 刘保平[1] 阮翘[1] 谢新立[1] 孙秉奇[1] 

机构地区：[1]郑州大学第一附属医院核医学科,450052

出　　处：《中华核医学杂志》2006年第5期264-267,共4页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨非小细胞肺癌^(99)Tc^m-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)显像与其恶性程度、乏氧诱导因子-1α(HIF-1α)表达的关系。方法 35例非小细胞肺癌患者,注射^(99)Tc^m-HL91后4 h 进行胸部前后位、后前位平面及断层显像,利用感兴趣区(ROI)技术,计算肿瘤与对侧正常组织(T/N)的放射性比值。所有患者均行组织病理学检查,标本行 HE 染色、免疫组织化学染色。结果 ^(99)Tc^m-HL91平面显像:35例非小细胞肺癌患者中30例显像阳性;断层显像:33例显像阳性。定量分析:4 h断层像 T/N 比值明显高于平面像(t=10.619,P=0.000);HL91显像的T/N 比值与肺癌细胞恶性程度相关(r=0.626,P=0.000),鳞癌、腺癌之间的 T/N 比值差异无显著性(t=0.981,P=0.330)。HIF-1α主要表达于肺癌细胞胞核及胞质,肿瘤间质细胞也可见少量表达,肿瘤坏死区周围及肿瘤浸润边缘部的癌细胞 HIF-1α表达明显增多。鳞癌、腺癌间的 HIF-1α表达差异无显著性(Z_c=1.295,P=0.730),HIF-1α表达强弱与肺癌细胞恶性程度相关(r_s=0.467,P=0.005),与肿瘤大小无关。非小细胞肺癌各组织学分级 HL91显像 T/N 比值与 HIF-1α表达强弱均高度相关(r=0.756～0.893,P<0.05)。结论 HL91显像的 T/N 比值与肺癌细胞恶性程度呈中度相关,与恶性肿瘤细胞 HIF-1α表达呈高度相关。HL91显像可以用来预测肿瘤恶性程度及放、化疗疗效。Objective To correlate the ^99Tcm-4,9-diaza-3,3,10,10-tetramethyldodecan-2, 11-dione dioxime （HL91） imaging with malignancy grading and hypoxia-inducible factor （HIF）-1α expression in non-small cell lung cancer （NSCLC） in human. Methods Thirty-five NSCLC patients underwent SPECT and planar imaging at 4 h ＇after injection of ^99Tcm-HL91. Regions of interest （ROIs） were drawn, and ratios of tumor-to-normal tissue （T/N） were calculated. All patients were operated and the excised samples were sent for pathological examination with hematoxylin and eosin stain and immunohistochemistry. Results In planar imaging 30 out of 35 NSCLC patients showed ^99Tcm-HL91 uptake, while in SPECT imaging 33 out of 35 patients were positive, However, T/N was higher in SPECT than in planar imaging（t = 10, 619, P = 0, 000）, The difference of T/N between squamous carcinoma and adenocarcinoma was not significant （t = 0. 981 ,P =0. 330）, And the uptake of ^99Tcm-HL91 was related to the malignancy of the cancer cells （ r = 0. 626,P = 0. 000）, HIF-1α was mainly expressed in the cytoplasm and nucleus of tumor cells, but seldom in the cytoplasm of mesenchymal cells. Besides, HIF-1α was evidently expressed in tumor cells at the periphery of necrosis and the margin of the tumor, The difference of expression between squamous carcinoma and adenocarcinoma was not significant（ Zc = 1. 295,P = 0. 730）, The expression magnitude was related to the malignancy of the cancer cell （rs = 0. 467, P = 0. 005 ） , not the size of tumor. However the uptake of 99Tcm-HL91 was strongly correlated to the expression magnitude of HIF-1α（ r = 0. 756 - 0. 893, P 〈 0.05 ）. Conclusions Uptake of HL91 and expression of HIF-I a are strongly correlated to the malignancy of the cancer cell, HL91 imaging may serve as an important non-invasive method in predicting the malignancy of the cancer cells and monitoring the effect of radiotherapy or chemotherapy.

关 键 词：癌 非小细胞肺 细胞低氧 体层摄影术 发射型计算机 单光子 HL91 乏氧诱导因子-1Α 

分 类 号：R734.2[医药卫生—肿瘤]