CAJ | 학술논문

背景与目的小细胞肺癌恶性程度高，早期诊断对其预后有重要价值，目前的检查方法比较局限，传统影像学方法特异性差，而PET/CT价格昂贵，难于推广应用。小细胞肺癌属神经内分泌肿瘤，高表达生长抑素受体，是其早期进行分子影像诊断的理论基石。本实验旨在观察99mTc-octreotide在正常裸鼠体内的分布、代谢及荷人NCI-H446小细胞肺癌裸鼠模型体内显像变化，为临床小细胞肺癌早期诊断奠定基础。方法建立人小细胞肺癌的裸鼠肿瘤模型，正常裸鼠及荷瘤鼠静脉注射99mTc-octreotide显像剂后行动态及延迟显像。运用感兴趣区（regionofin-terest,ROI）技术勾画各时相裸鼠各脏器、肿瘤（T）及肿瘤对侧对应部位（N）放射性计数，计算相应T/N比值，并建立30min内各ROI的时间-放射性（A-T）曲线。结果①正常裸鼠的肾脏、肝脏内99mTc-octreotide分布最多，肺部、心脏部位分布较低，头部放射性分布最少，99mTc-octreotide主要通过泌尿系统排泄；各脏器30min内A-T曲线显示放射性分布随时间延迟呈逐渐下降趋势。②5例荷瘤裸鼠的肿瘤显像均呈阳性；静脉注射99mTc-octreotide后肿瘤部位在3h显像最清楚，整个检查时间内肝脏放射性强度明显高于肿瘤组织，肺部放射性与肿瘤部位较相近。半定量分析结果显示，静脉注射99mTc-octreotide后肿瘤组织与对侧肢体肌肉的T/N比值在0.5h、2h、3h、4h分别为1.163±0.03、2.08±0.12、3.03±0.23、2.689±0.31；各时相T/N比值差异有统计学意义（F=51.69,P<0.000,1）；通过两两比较发现，静脉注射显像剂后3h的T/N比值与其他各时相差异均有统计学意义（P<0.05）；不同检查时间肝脏部位的放射性平均计数高于肿瘤部位，肺部的平均计数与肿瘤相近。肿瘤部位A-T曲线显示，注射99mTc-octreotide后2min-3min出现一过性放射性分布高峰。结论运用99mTc-octreotide作显像剂，人小细胞肺癌NCI-H446裸鼠模型具有极高的显像阳性率，且3h肿瘤显像最清楚。揹景與目的小細胞肺癌噁性程度高，早期診斷對其預後有重要價值，目前的檢查方法比較跼限，傳統影像學方法特異性差，而PET/CT價格昂貴，難于推廣應用。小細胞肺癌屬神經內分泌腫瘤，高錶達生長抑素受體，是其早期進行分子影像診斷的理論基石。本實驗旨在觀察99mTc-octreotide在正常裸鼠體內的分佈、代謝及荷人NCI-H446小細胞肺癌裸鼠模型體內顯像變化，為臨床小細胞肺癌早期診斷奠定基礎。方法建立人小細胞肺癌的裸鼠腫瘤模型，正常裸鼠及荷瘤鼠靜脈註射99mTc-octreotide顯像劑後行動態及延遲顯像。運用感興趣區（regionofin-terest,ROI）技術勾畫各時相裸鼠各髒器、腫瘤（T）及腫瘤對側對應部位（N）放射性計數，計算相應T/N比值，併建立30min內各ROI的時間-放射性（A-T）麯線。結果①正常裸鼠的腎髒、肝髒內99mTc-octreotide分佈最多，肺部、心髒部位分佈較低，頭部放射性分佈最少，99mTc-octreotide主要通過泌尿繫統排洩；各髒器30min內A-T麯線顯示放射性分佈隨時間延遲呈逐漸下降趨勢。②5例荷瘤裸鼠的腫瘤顯像均呈暘性；靜脈註射99mTc-octreotide後腫瘤部位在3h顯像最清楚，整箇檢查時間內肝髒放射性彊度明顯高于腫瘤組織，肺部放射性與腫瘤部位較相近。半定量分析結果顯示，靜脈註射99mTc-octreotide後腫瘤組織與對側肢體肌肉的T/N比值在0.5h、2h、3h、4h分彆為1.163±0.03、2.08±0.12、3.03±0.23、2.689±0.31；各時相T/N比值差異有統計學意義（F=51.69,P<0.000,1）；通過兩兩比較髮現，靜脈註射顯像劑後3h的T/N比值與其他各時相差異均有統計學意義（P<0.05）；不同檢查時間肝髒部位的放射性平均計數高于腫瘤部位，肺部的平均計數與腫瘤相近。腫瘤部位A-T麯線顯示，註射99mTc-octreotide後2min-3min齣現一過性放射性分佈高峰。結論運用99mTc-octreotide作顯像劑，人小細胞肺癌NCI-H446裸鼠模型具有極高的顯像暘性率，且3h腫瘤顯像最清楚。
배경여목적소세포폐암악성정도고，조기진단대기예후유중요개치，목전적검사방법비교국한，전통영상학방법특이성차，이PET/CT개격앙귀，난우추엄응용。소세포폐암속신경내분비종류，고표체생장억소수체，시기조기진행분자영상진단적이론기석。본실험지재관찰99mTc-octreotide재정상라서체내적분포、대사급하인NCI-H446소세포폐암라서모형체내현상변화，위림상소세포폐암조기진단전정기출。방법건립인소세포폐암적라서종류모형，정상라서급하류서정맥주사99mTc-octreotide현상제후행동태급연지현상。운용감흥취구（regionofin-terest,ROI）기술구화각시상라서각장기、종류（T）급종류대측대응부위（N）방사성계수，계산상응T/N비치，병건립30min내각ROI적시간-방사성（A-T）곡선。결과①정상라서적신장、간장내99mTc-octreotide분포최다，폐부、심장부위분포교저，두부방사성분포최소，99mTc-octreotide주요통과비뇨계통배설；각장기30min내A-T곡선현시방사성분포수시간연지정축점하강추세。②5례하류라서적종류현상균정양성；정맥주사99mTc-octreotide후종류부위재3h현상최청초，정개검사시간내간장방사성강도명현고우종류조직，폐부방사성여종류부위교상근。반정량분석결과현시，정맥주사99mTc-octreotide후종류조직여대측지체기육적T/N비치재0.5h、2h、3h、4h분별위1.163±0.03、2.08±0.12、3.03±0.23、2.689±0.31；각시상T/N비치차이유통계학의의（F=51.69,P<0.000,1）；통과량량비교발현，정맥주사현상제후3h적T/N비치여기타각시상차이균유통계학의의（P<0.05）；불동검사시간간장부위적방사성평균계수고우종류부위，폐부적평균계수여종류상근。종류부위A-T곡선현시，주사99mTc-octreotide후2min-3min출현일과성방사성분포고봉。결론운용99mTc-octreotide작현상제，인소세포폐암NCI-H446라서모형구유겁고적현상양성솔，차3h종류현상최청초。
Background and objective For highly aggressive small cell lung cancer (SCLC), early diagnosis is im-portant for its prognosis, but the current inspection methods are more limited, with poor specificity of the traditional imaging methods, and the high cost of PET/CT, difcult to popularization and application. SCLC is kind of neuroendocrine tumors, high expression of somatostatin receptors, which is the cornerstone of its early molecular imaging diagnosis. Te aim of this study is to observe the biodistribution and metabolism of 99mTc-octreotide in normal and the human SCLC bearing nude mice. Methods Dynamic and static scintigraphy at 0.5 h, 2 h, 3 h, 4 h were performed in both normal and tumor bearing nude mice afer intravenous injection of 99mTc-octreotide. Te technique of drawing region of interest (ROI) was used to obtain the aver-aged pixel counts and the activity-time (A-T) curve of brain, heart, lung, liver, kidney, tumor, respectively. Results ① Te biodistribution study in normal nude mice showed highest uptake in kidney and liver, lower in lung and heart, lowest in brain. Most 99mTc-octreotide was excreted via kidney. ② All tumors were displayed clearly at 3 h postinjection of 99mTc-octreotide. Te averaged T/N ratio at 0.5 h, 2 h, 3 h, 4 h postinjection of 99mTc-octreotide was 1.163±0.03, 2.08±0.12, 3.03±0.23, 2.689±0.31, respectively (F=51.69, P<0.000,1). Te radioactivity of tumor was lower than liver, and similar with the lung. Te curve of tu-mor showed a radioactivity peak at 2 min-3 min postinjection. Conclusion 99mTc-octreotide receptor imaging on nude mice bearing SCLC shares high positive rate, especially at 3 h postinjection.