^99Tcm-MIBI显像在乳腺癌新辅助化疗中的应用价值  

Clinical value of ^99Tcm-MIBI imaging in neoadjuvant chemotherapy of breast cancer

作　　者：陈伟君[1] 孙达[2] 

机构地区：[1]宁波大学附属医院医学影像中心,315020 [2]浙江大学医学院附属第二医院核医学科,杭州310009

出　　处：《国际放射医学核医学杂志》2015年第6期487-492,共6页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目前，新辅助化疗（NAG）已成为局部晚期乳腺癌的标准治疗方法，而肿瘤的多药耐药性（MDR）是乳腺癌NAC失败的主要原因之一。MDR的产生与mdrl编码的P-糖蛋白（P—gP）介导的耐药机制有关。99Tcm-MIBI是一种肿瘤阳性显像剂，也是P—gp的作用底物，可作为非侵入性的体内显像方法用于评估不同肿瘤中P-gP介导的耐药机制。研究显示，^99Tcm-MIBI早期显像反映MIBI进入肿瘤细胞的多少及速率，并与其恶性程度密切相关，可用于NAC疗效的评估；而延迟显像反映MIBI被排出肿瘤细胞外的量及速度，并与细胞膜P—gp的表达及MDR密切相关，可无创性地检测由P-gp引起的多药耐药，预测NAC的敏感性。Neoadjuvant chemotherapy （NCT） has become a standard therapeutic method for focal advanced breast carcinoma. The muhidrug resistance （MDR） of tumors is one of the main causes of chemotherapy failure in breast cancer. MDR development involves the transmembrane P-glycoprotein （P- gp） encoded by the MDR gene MDR1.^99Tcm-methoxyisobutylisonitrile （MIBI） is a radiotracer for seintigraphy of tumors. MIBI is also a transport substrate for P-gp and has been used in assessing P-gp- mediated MDR in a variety of tumors. The nuclear medicine community in the USA has suggested the use of ^99Tcm-MIBI scintigraphy as a noninvasive method in in vivo imaging of MDR. Studies have shown that early imaging of ^99Tcm-MIBI reveals the accumulative quantity of MIBI in breast tumors, and correlated with malignant extent of tumor. Thus, early imaging through ^99Tcm-MIBI can be conducted to evaluate the curative effect of NCT in breast cancer. Delayed imaging reveals the washout rates of MIBI from breast tumors, which is correlated with P-gp expression and MDR. Thus, delayed ^99Tcm-MIBI may provide important information on P-gp-mediated MDR and may predict chemotherapy sensitivity.

关 键 词：乳腺肿瘤 99M锝甲氧基异丁基异腈 多药耐药相关蛋白类 P-糖蛋白 新辅助 化疗 疗效评估 

分 类 号：R730.53[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R737.9