以谷氨酰胺合成酶为靶点的^13N—NH3PET／CT显像在前列腺癌诊断中的应用研究  

Diagnostic value of 13N-ammonia PET/CT imaging targeting glutamine synthetase expression in patients with prostate cancer

作　　者：张雪珍[1] 史新冲[1] 何巧[1] 易畅[1] 张芳玲[1] 张祥松[1] 

机构地区：[1]中山大学附属第一医院核医学科,广州510080

出　　处：《中华核医学与分子影像杂志》2016年第1期25-29,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家自然科学基金（81271599）

摘　　要：目的探讨以谷氨酰胺合成酶（GS）为靶点的^13N—NH，PET／CT显像对前列腺癌诊断的应用价值。方法利用Western blot和PCR定量分析PC3和DU145前列腺癌细胞Gs的表达量，并分析2个细胞株^13”N-NH3摄取的情况。选取34例可疑前列腺癌患者进行^13N—NH，PET／CT检查，穿刺活组织病理检查分析Gleason评分，免疫组织化学检查定量分析GS表达水平，对6分区的SUVmax、GS表达评分和Gleason评分的相关性行Spearman相关分析。采用单因素方差分析及最小显著差异t检验分析数据。结果随着培养液中谷氨酰胺浓度减低，前列腺癌细胞中GSmRNA和相关蛋白含量均逐步增加，^13N—NH3的摄取也逐步增加；加入GS抑制剂后，细胞的^13N—NH3摄取均显著下降。免疫组织化学检查结果显示，前列腺癌组织GS表达评分（7．76±2．57）显著高于良性前列腺增生（BPH）和前列腺炎组织（3．98±2．60和3．34±0．36；F=36．85，P〈0．05；t=7．97和4．45，均P〈0．05）；GS表达评分与Gleason评分之间存在弱相关性（rs=0．52，P〈0．05）。34例患者中，前列腺癌病灶分区的^13N—NH3摄取（SUVmax2．08±1．14）显著高于BPH分区和前列腺炎分区（SUVmax1．56±0．58和1．14±0．22；F=5．966，P〈0．05；t=2．63和2．65。均P〈0．05）；前列腺癌组织GS表达评分与对应区域^13N-NH3的SUVmax之间存在弱相关性（rs=0．47，P〈0．05）。结论GS表达是前列腺癌摄取^13N-NH3的决定因素，前列腺癌病灶普遍存在GS表达上调，^13N-NH3显像有助于前列腺癌病灶的检测和诊断。Objective To investigate the expression of glutamine synthetase （GS） in prostate cancer and the utility of ^13N-NH3 PET/CT in detecting prostate cancer. Methods The uptake ratio of ^13N- NH3 and the expression of GS in PC3 and DU145 cells were measured by Western blot and PCR methods. A total of 34 patients with suspected prostate cancer underwent ^13N-NH3 PET/CT imaging and prostate biopsy. Immunohistochemistry staining of GS was performed and Gleason scores of tumors were evaluated. One-way analysis of variance, the least significant difference-t test and Spearman correlation analysis were used to analyze data. Results The uptake of ^13N-ammonia in PC3 and DU145 cells elevated along with the decrease of glutamine in medium. The expression of GS mRNA and protein also increased when glutamine was decreased. In biopsy samples, the mean GS expression scores of prostate cancer, benign prostatic hyperplasia （BPH） and prostatitis were 7.76±2.57, 3.98±2.60, 3.34±0.36, respectively （ F= 36.85, t1 = 7.97, t2 = 4. 45, all P〈0.05）, which had a weak correlation with Gleason scores （r = 0.52, P〈0.05）. In 34 patients, the mean SUVmax of prostate cancer segments （1.56±0.58 and 1.14±0.22; F=5.966, t1 =2.63, t2=2.65, all P〈0.05）. There was a weak correlation between GS expression scores and the uptake of 13N-ammonia in prostate cancer （rs =0.47, P〈0.05）. Conclusions Up-regulated expression of GS is common in prostate cancer cells. GS is the main reason for the uptake of 13N-ammonia, which is a useful tracer for prostate cancer imaging.

关 键 词：前列腺肿瘤 体层摄影术 发射型计算机 体层摄影术 X线计算机 氮放射性同位素 NH3 谷氨酰胺合成酶 

分 类 号：R737.25[医药卫生—肿瘤]