Correlation of hypoxia as measured by fluorine-18 fluoroerythronitroimidazole (18F-FETNIM) PET/CT and overall survival in glioma patients
Correlation of hypoxia as measured by fluorine-18 fluoroerythronitroimidazole (18F-FETNIM) PET/CT and overall survival in glioma patients
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DOI：
10.1007/s00259-019-04621-z
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发表时间：
2019-11-28
影响因子：
9.1
通讯作者：
Yu, Jinming
中科院分区：
文献类型：
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作者：
Hu, Man;Zhu, Yufang;Yu, Jinming
目的缺氧在人脑胶质瘤的生物学过程中起重要作用。正电子发射断层扫描/计算机断层扫描（PET/CT）与缺氧示踪剂提供了一种非侵入性的方法来区分个体肿瘤生物学和潜在的修改恶性肿瘤患者的治疗。本研究的目的是确定乏氧是否与肿瘤分级、总生存期（OS）以及与乏氧、增殖、血管生成和胶质瘤侵袭相关的免疫组化特征相关，乏氧通过氟-18-氟代硝基咪唑（F-18-FETNIM）PET/CT测量。程序25例胶质瘤患者中，可以安全地尝试最大限度的总切除进行了分析。所有患者在手术前均接受了F-18-FETNIM PET/CT研究。从肿瘤组织的PET图像获得最大标准化摄取值（SUVmax）。立体定向获得肿瘤标本，用于缺氧诱导因子-1 α（HIF-1 α）、Ki-67、血管内皮生长因子（VEGF）和基质金属蛋白酶9（MMP-9）的免疫组织化学染色。结果SUVmax与胶质瘤分级相关（r = 0.881，P < 0.001）。SUVmax与HIF-1 α、Ki-67、VEGF和MMP-9的表达显著相关（r = 0.820、0.747、0.606和0.727;均P < 0.001）。SUVmax高的患者的3年OS明显低于SUVmax低的患者（24.4%与82.1%，P = 0.003）。结论F-18-FETNIM PET/CT是一种无创性评价脑胶质瘤乏氧状态的良好方法。它可用于了解缺氧影响胶质瘤患者OS的机制。
Purpose Hypoxia is important in the biology of glioma in humans. Positron emission tomography/computed tomography (PET/CT) with a hypoxia tracer offers a noninvasive method to differentiate individual tumor biology and potentially modify treatment for patients with malignancies. The purpose of this study was to determine whether hypoxia, as measured by fluorine-18 fluoroerythronitroimidazole (F-18-FETNIM) PET/CT, was associated with tumor grade, overall survival (OS), and immunohistochemical features related to hypoxia, proliferation, angiogenesis, and the invasion of gliomas. Procedures Twenty-five patients with gliomas in whom gross maximal resection could be safely attempted were analyzed. All patients underwent F-18-FETNIM PET/CT studies before surgery. The maximum standardized uptake value (SUVmax) was obtained from the PET images of tumor tissues. Tumor specimens were stereotactically obtained for the immunohistochemical staining of hypoxia-inducible factor-1 alpha (HIF-1 alpha), Ki-67, vascular endothelial growth factor (VEGF), and matrix metalloproteinase 9 (MMP-9). Results A correlation between the SUVmax and glioma grade was found (r = 0.881, P < 0.001). The SUVmax was significantly correlated with the expression of HIF-1 alpha, Ki-67, VEGF, and MMP-9 (r = 0.820, 0.747, 0.606, and 0.727; all P < 0.001). Patients with a high SUVmax had significantly worse 3-year OS than those with a low SUVmax (24.4% vs. 82.1%, P = 0.003). Conclusions F-18-FETNIM PET/CT provides an excellent noninvasive assessment of hypoxia in glioma. It can be used to understand the mechanisms by which hypoxia affects the OS of glioma patients.