乳腺癌淋巴微转移模型的建立及皮内与静脉注射^18F-脱氧葡萄糖的诊断效果  

Establishing and diagnosis of lymph node micrometastasis with subcutaneous or intravenous injection of ^(18)F-FDG by PET/CT imaging in mouse breast cancer

作　　者：李永霞 郑营营[1,2,3] 孙玉云 何思敏 罗建民 张建平[1,2,3,4] 曹天野 王明伟[1,2,3,4] 章英剑 LI Yongxia;ZHENG Yingying;SUN Yuyun;HE Simin;LUO Jianmin;ZHANG Jianping;CAO Tianye;WANG Mingwei;ZHANG Yingjian(Department of Nuclear Medicine,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Center of Biomedical imaging,Fudan University,Shanghai 200032,China;Shanghai Proton Heavy Ion Center,Shanghai 201315,China;Shanghai Engineering Research Center of Molecular Imaging Probe,Shanghai 200032,China)

机构地区：[1]复旦大学附属肿瘤医院核医学科,复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学生物医学影像研究中心,上海200032 [3]上海市质子重离子医院核医学科,上海201315 [4]上海分子影像探针工程技术研究中心,上海200032

出　　处：《肿瘤影像学》2018年第3期164-168,共5页Oncoradiology

基　　金：国家自然科学基金青年科学基金(81401514)

摘　　要：目的:探讨乳腺癌小鼠区域性局部皮内和静脉注射^(18)F-脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)后瘤周淋巴结PET/CT成像的差异,评估^(18)F-FDG在肿瘤淋巴结微转移中的成像效果。方法:构建4T1原位乳腺癌淋巴结微转移模型,区域性局部皮内和次日静脉注射^(18)F-FDG,进行小动物PET/CT显像,对淋巴结摄取^(18)F-FDG较高者隔日再行瘤周局部皮内注射锝硫胶体(technetium sulfur colloid,99mTc-SC)后行小动物SPECT/CT成像。显像完成后,取淋巴结组织进行H-E染色,以及上皮细胞角蛋白5/6(cytokeratin 5/6,CK5/6)和葡萄糖转运蛋白1(glucose transporter-1,Glut-1)免疫组织化学染色。结果:局部皮内注射时,有微转移的小鼠瘤周淋巴结摄取^(18)F-FDG异常增高,ID%/g值为19.2±2.0(n=2),显著高于对照(自身对照时对侧淋巴结;ID%/g值为6.8±0.4)和无转移小鼠(ID%/g值为7.2±0.4)相同位置淋巴结(P<0.001)。静脉注射时,未发现任何小鼠淋巴结摄取异常增高(ID%/g值为2.5±0.5;P=0.870)。局部皮内注射99mTc-SC时,可观测到多个腋淋巴结,其中1个瘤周淋巴结与^(18)F-FDG高摄取淋巴结位置相吻合。H-E染色和CK5/6免疫组织化学染色证实,^(18)F-FDG高摄取的淋巴结为发生微转移的淋巴结。结论:区域性局部皮内注射^(18)F-FDG能定性前哨淋巴结,比静脉注射法早期发现肿瘤微转移淋巴结。Objective： To investigate the difference in the identification of lymph node micrometastasis between regional subcutaneous injection and intravascular injection of ^18F-fluorodeoxyglucose（^18F-FDG） by PET/CT imaging in mouse breast cancer. Methods： The mouse 4 T1 breast cancer lymph node micrometastasis model was established. The regional subcutaneous and intravascular injection of ^18F-FDG was performed for PET/CT imagingin two day, respectively. For the higher ^18F-FDG uptake in lymph node of mice, SPECT/CT imaging was also performed by subcutaneous injection of technetium sulfur colloi（99 mTc-SC）. H-E staining and immunohistochemistry of epithelial cytokeratin 5/6（CK5/6） and glucose transporter 1（Glut-1） were measured. Results： The uptake value（ID%/g） of ^18F-FDG in lymph nodes was 19.2±2.0（n=2） by subcutaneous injection in micrometastasis group, which was significantly higher than the contralateral ones（ID%/g of 6.8±0.4） and those without micrometastasis（ID%/g of 7.2±0.4）（P〈0.000 1）. No increased uptake of ^18F-FDG was observed in any mouse lymph node（ID%/g of 2.5±0.5）（P=0.870） by intravascular injection. Moreover, SPECT/CT imaging with ^99mTc-SC revealed multiple axillary lymph nodes, one of which had a well-matched lymph node with high ^18F-FDG uptake. H-E staining and immunohistochemistry of CK5/6 confirmed that high ^18F-FDG uptake in lymph nodes revealed micrometastatic. Conclusion： Regional subcutaneous injection of ^18F-FDG can qualitatively identify micrometastatic sentinel lymph nodes earlier than intravenous injection, which is worthy of clinical application.

关 键 词：乳腺癌 淋巴结微转移 皮内注射 静脉注射 ^18F-脱氧葡萄糖PET/CT成像 

分 类 号：R737.9[医药卫生—肿瘤]