Usefulness of 99mTc-sestamibi scintigraphy in suggesting the therapeutic effect of chemotherapy against gastric cancer
Usefulness of 99mTc-sestamibi scintigraphy in suggesting the therapeutic effect of chemotherapy against gastric cancer
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DOI：
10.1158/1078-0432.ccr-1072-3
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发表时间：
2004-06-01
影响因子：
11.5
通讯作者：
Takabayashi, A
中科院分区：
文献类型：
--
作者：
Kawata, K;Kanai, M;Takabayashi, A
目的：用Tc-99 m-MIBI（Tc-99 m-MIBI）成像已被用于评估170 kDa P-糖蛋白（P-gp）表达，并预测几种类型的恶性肿瘤（如乳腺癌和肺癌）的化疗反应。本研究的目的是评价胃癌患者肿瘤中Tc-99 m-MIBI蓄积与化疗敏感性的关系。实验设计：36例进展期胃癌患者在化疗前进行了Tc-99 m-MIBI核素显像。同时行内镜活检，免疫组化法检测P-gp和多药耐药相关蛋白的表达。结果：36例胃癌患者中，25例在早期（30 min）显像时肿瘤内有较高的Tc-9 m-MIBI蓄积，23例在延迟（120 min）显像时肿瘤内有较高的Tc-9 m-MIBI蓄积。胃癌组织中Tc-99 m-MIBI的加速蓄积与P-gp的表达增加呈负相关，但与多药耐药相关蛋白的表达无关。高Tc-99 m-MIBI蓄积患者对5-FU/顺二氨二氯铂（H）化疗的有效率（15.4%）明显低于低Tc-99 m-MIBI蓄积患者（54.5%）。结论：99 m-Tc-MIBI显像对晚期胃癌化疗反应有一定的预测价值。
Purpose: Imaging with Tc-99m-sestamibi (Tc-99m-MIBI) has been used to assess 170-kDa P-glycoprotein (P-gp) expression and predict chemotherapy responses in several types of malignancy, such as breast and lung cancers. The purpose of this study was to evaluate the relationship between Tc-99m-MIBI accumulation in tumors and sensitivity to chemotherapy in gastric cancer patients.Experimental Design: Thirty-six patients with advanced gastric cancer underwent Tc-99m-MIBI scintigraphy before chemotherapy. Patients also underwent endoscopic biopsy' and the expression of P-gp or multidrug resistance-associated protein was analyzed by immunohistochemical staining. The relationship between the accumulation of Tc-99m-MIBI in tumors and responses to chemotherapy with 5-fluorouracil/cis-diamminedichloroplatinum(II) or epirubicin was examined.Results: Higher accumulation of Tc-9m-MIBI in tumors was observed in 25 and 23 of 36 gastric cancer patients at the early (30 min) and delayed (120 min) images, respectively. Accelerated accumulation of Tc-99m-MIBI negatively correlates with increased expression of P-gp, but not of multidrug resistance-associated protein, as determined by immunohistochemistry in gastric cancer tissues. The response rate to 5-fluorouracil/cis-diamminedichloroplatinum(H) chemotherapy in patients with high Tc-99m-MIBI accumulation (15.4%) was much lower than that in patients with low Tc-99m-MIBI accumulation (54.5%). In contrast, patients with high Tc-99m-MIBI accumulation show a higher response rate (41.7%) to chemotherapy with epirubicin, which is known to be a substrate of P-gp transporter.Conclusions: Tc-99m-MIBI scintigraphy is useful to suggest the responses to chemotherapy of patients with advanced gastric cancer.