Nectin‑4靶向探针68Ga‑N188在胰腺癌诊断中的应用价值  

Application value of Nectin‐4 targeting radiotracer 68Ga-N188 in the diagnosis of pancreatic cancer

作　　者：王建鑫 马永蔌[1] 刘伟康 陈雪祺[2] 陈依然[1] 朱昱 张继新[3] 张建华[2] 杨兴 田孝东[1] 杨尹默[1] Wang Jianxin;Ma Yongsu;Liu Weikang;Chen Xueqi;Chen Yiran;Zhu Yu;Zhang Jixin;Zhang Jianhua;Yang Xing;Tian Xiaodong;Yang Yinmo(Department of Hepatobiliary and Pancreatic Surgery,Peking University First Hospital,Beijing 100034,China;Department of Nuclear Medicine,Peking University First Hospital,Beijing 100034,China;Department of Pathology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院肝胆胰外科,北京100034 [2]北京大学第一医院核医学科,北京100034 [3]北京大学第一医院病理科,北京100034

出　　处：《中华消化外科杂志》2024年第5期746-753,共8页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(82171722、82271764);中央高水平医院临床科研业务费资助(北京大学第一医院青年临床研究专项2023YC06)。

摘　　要：目的探讨Nectin‑4靶向探针68Ga‑N188在胰腺癌诊断中的应用价值。方法采用前瞻性研究方法。选取2022年8—12月北京大学第一医院收治的16例经增强CT检查诊断为胰腺癌患者的临床病理资料;男9例,女7例;年龄为(62±8)岁。患者均行18氟‑脱氧葡萄糖(18F‑FDG)和68Ga‑N188正电子发射断层显像(PET)/CT检查。观察指标:(1)68Ga‑N188在患者不同组织和肿瘤原发灶中的分布。(2)胰腺肿瘤中Nectin‑4的表达和68Ga‑N188的摄取。(3)68Ga‑N188与18F‑FDG的PET/CT检查结果比较。正态分布的计量资料以x±s表示,组间比较采用独立样本t检验。计数资料以绝对数或百分率表示。结果(1)68Ga‑N188在患者不同组织和肿瘤原发灶中的分布。PET/CT检查结果显示:注射后1 h,68Ga‑N188在16例患者脂肪、肌肉、皮肤、脑组织中的最大标准摄取值(SUVmax)和平均标准摄取值(SUVmean)分别为0.40±0.16和0.25±0.09、0.68±0.20和0.44±0.12、0.39±0.14和0.28±0.11、0.09±0.04和0.05±0.02;在食管、肝脏、脾脏、胰腺组织中,上述指标分别为1.53±0.48和1.16±0.31、1.49±0.45和0.91±0.30、1.40±0.30和1.02±0.24、1.24±0.31和0.96±0.25;在肿瘤原发灶中,上述指标分别为3.28±1.02和2.14±0.62,与胰腺组织比较,差异均有统计学意义(t=8.03,6.75,P<0.05)。肿瘤原发灶中,基于SUVmax的肿瘤背景比为1.82±0.58。(2)胰腺肿瘤中Nectin‑4的表达和68Ga‑N188的摄取。免疫组织化学染色结果显示:16例患者中,Nectin‑4高表达7例,低表达9例。PET/CT检查结果显示:7例Nectin‑4高表达和9例低表达患者肿瘤原发灶中,68Ga‑N188的SUVmax分别为3.77±1.10和2.64±0.68,两者比较,差异有统计学意义(t=2.64,P<0.05)。18F‑FDG在7例Nectin‑4高表达和9例低表达患者肿瘤原发灶中的SUVmax分别为6.73±3.24和6.43±3.45,两者比较,差异无统计学意义(t=0.17,P>0.05)。(3)68Ga‑N188与18F‑FDG的PET/CT检查结果比较。16例患者中,14例经术后组Objective To investigate the application value of nectin‐4 targeting radiotracer 68Ga‐N188 in the diagnosis of pancreatic cancer.Methods The prospective study was conducted.The clinicopathologic data of 16 patients diagnosed as pancreatic cancer on enhanced computed tomography(CT)who were admitted to the Peking University First Hospital from August to December 2022 were collected.There were 9 males and 7 females,aged(62±8)years.All patients underwent 18F‐flurodeoxyglucose(18F‐FDG)and 68Ga‐N188 positron emission tomography(PET)/CT examina‐tion.Observation indicators:(1)distribution of 68Ga‐N188 in different tissues and tumor primary lesion of patients;(2)expression of Nectin‐4 and uptake of 68Ga‐N188 in pancreatic cancer;(3)com‐parison of examination results between 68Ga‐N188 and 18F‐FDG PET/CT.Measurement data with nor‐mal distribution were represented as Mean±SD,and comparison between groups was conducted using the independent sample t test.Count data were described as absolute numbers or percentages.Results(1)Distribution of 68Ga‐N188 in different tissues and tumor primary lesion of patients.Results of PET/CT examination showed that in 1 hour after injection,the maximum standard uptake value(SUVmax)and mean standard uptake value(SUVmean)of 68Ga‐N188 in fat,muscle,skin,and brain tissues of 16 patients were 0.40±0.16 and 0.25±0.09,0.68±0.20 and 0.44±0.12,0.39±0.14 and 0.28±0.11,0.09±0.04 and 0.05±0.02,respectively.In the tissues of the esophagus,liver,spleen,and pancreas,the above indicators were 1.53±0.48 and 1.16±0.31,1.49±0.45 and 0.91±0.30,1.40±0.30 and 1.02±0.24,1.24±0.31 and 0.96±0.25,respectively.In tumor primary lesion,the above indicators were 3.28±1.02 and 2.14±0.62,respectively,showing significant differences in SUVmax and SUVmean compared with pancreatic tissue(t=8.03,6.75,P<0.05).The tumor background ratio in tumor pri‐mary lesion based on SUVmax was 1.82±0.58.(2)Expression of Nectin‐4 and uptake of 68Ga‐N188 in pancreatic cancer.Results of imm

关 键 词：胰腺肿瘤 诊断 Nectin细胞黏附分子4 68Ga‑N188 应用 

分 类 号：R735.9[医药卫生—肿瘤]