Intraindividual tumor heterogeneity in NET-Further insight by C-X-C motif chemokine receptor 4-directed imaging.
Intraindividual tumor heterogeneity in NET-Further insight by C-X-C motif chemokine receptor 4-directed imaging.
复制标题
通过 C-X-C 基序趋化因子受体 4 定向成像进一步了解 NET 中的个体肿瘤异质性。
DOI：
10.1007/s00259-016-3566-3
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Lapa C.
中科院分区：
文献类型：
--
作者：
Werner RA;Weich A;Schirbel A;Samnick S;Buck AK;Higuchi T;Wester HJ;Lapa C.
1例67岁男性，有G3（Ki 67：80%）胃神经内分泌肿瘤（NET）病史，转诊使用[18 F]-氟脱氧葡萄糖（[18 F] FDG）和生长抑素受体（SSTR）正电子发射断层扫描/计算机断层扫描（PET/CT），使用[68 Ga]-DOTA-D-Phe-Tyr 3-奥曲肽（[68 Ga] DOTATOC）进行再分期。此外，使用[68 Ga] Pentixafor PET/CT进行CXC基序趋化因子受体4-（CXCR 4-）定向成像，以进行腔内放射治疗评价。影像学检查显示多处肝转移。值得注意的是，可记录显著异质性，包括SSTR+/FDG+/CXCR 4-（黄色箭头）、仅FDG+以及FDG+/CXCR 4+病变（白色箭头）。SSTR和CXCR 4的表达并没有表现出显著的一致性，而[18 F] FDG和[68 Ga] DOTATOC阳性的不同模式是众所周知的，并且已经在许多研究中描述[1-3]，这是第一份通过研究NET中CXCR 4表达谱对肿瘤异质性复杂性的有价值的补充性见解的报告，描述为更具侵略性的组织学[4]。这一观察结果可能对G2 NET患者特别感兴趣，其中CXCR 4阳性可能表示更具侵袭性的疾病，或者在G3 NET中，高受体表达可能代表新的治疗选择[5]，特别是在晚期疾病阶段。进一步的研究是必要的，以阐明潜在的机制或预后的影响。
A 67-year-old man with a history of a G3 (Ki67: 80%) neuroendocrine tumor (NET) of the stomach was referred for restaging with [18F]-fluorodeoxy-glucose ([18F] FDG) and somatostatin receptor (SSTR) positron emission tomography/computed tomography (PET/CT) using [68Ga]-DOTA-D-Phe-Tyr3-octreotide ([68Ga] DOTATOC). Additionally, CXC motif chemokine receptor 4-(CXCR4-) directed imaging with [68Ga] Pentixafor PET/CT for endoradiotherapy evaluation was performed. Imaging revealed multiple hepatic metastases. Of note, marked heterogeneity, including SSTR+/FDG+/CXCR4-(yellow arrows), exclusively FDG+ as well as FDG+/CXCR4+ lesions (white arrows) could be recorded. SSTR and CXCR4 expression did not demonstrate a significant coincidence.Whereas different patterns of [1 8 F] FDG and [68Ga] DOTATOC positivity are well-known and have been described in a number of studies [1–3], this is the first report demonstrating valuable complementary insight into the complexity of tumor heterogeneity by investigation of the CXCR4 expression profile in NET in which receptor overexpression has been described with more aggressive histology [4]. This observation might be especially interesting for G2 NET patients in whom CXCR4 positivity might denote more aggressive disease or in G3 NET in which high receptor expression might represent a new therapy option [5], in particular in advanced disease stages. Further research is warranted to elucidate the underlying mechanisms or prognostic implications.