FDG PET in cancer-associated venothromboembolic disease

FDG PET 在癌症相关静脉血栓栓塞性疾病中的应用

• 批准号: 7280378
• 负责人: Kathryn Ann Morton
• 金额: $ 45.94万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7280378
• 关键词: Abdomen; Acute; Blood Clot; Blood Platelets; Blood coagulation; Cancer Patient; Cells; Cessation of life; Coagulation Process; Data; Deformity; Development; Diagnosis; Disease; Effector Cell; Event; High-Risk Cancer; Immune response; In Vitro; Inflammation; Inflammatory; Leukocytes; Link; Malignant Neoplasms; Methods; Morbidity - disease rate; Myelogenous; PET/CT scan; Patients; Pelvis; Positron-Emission Tomography; Prevention; Proteins; Risk; Sensitivity and Specificity; Staging; Standards of Weights and Measures; Testing; Therapeutic; Thromboplastin; Thrombosis; base; cytokine; fluorodeoxyglucose positron emission tomography; human subject; molecular imaging; tool; uptake

DESCRIPTION (provided by applicant): The association between blood clot formation, inflammation and cancer is strong. Cancer predisposes patients to the development of blood clots, which may complicate therapy and has a higher risk of morbidity and death than in non-cancer patients. The converse is also true, nearly 50% of patients who develop unprovoked venothromboembolic disease (VTE) harbor an occult cancer, yet a search for cancer in these patients is not considered standard of practice. The diagnosis of blood clot formation is compromised when the clot is in the abdomen or pelvis, and/or the patient has a containdication to iodinated contrast. In cancer patients, multiple anatomic abnormalities associated with the cancer or its treatment, and a heightened propensity for intraabdominal or pelvic clot may further complicate the diagnosis of VTE. Further, no current methods exist to identify patients at particularly high risk for cancer-related thrombosis, a critical step in thrombo-prevention. The link between clot, cancer and inflammation may be due to a host response to cancer resulting in expression of both local and systemic inflammatory cytokines and tissue factors that act on platelets and myeloid leukocytes to produce a cascade of events culminating in blood clot formation. FDG PET imaging has emerged as a powerful tool in the diagnosis, staging, and therapeutic assessment of malignancy. Based on preliminary data and personal observation, we hypothesize that FDG PET may be a useful adjunct in the diagnosis of complicated cases of VTE, in identifying patients with unprovoked VTE that harbor an occult malignancy, and in identifying the systemic state that predisposes many cancer patients to VTE. The specific aims of this project will test these hypotheses in human subjects and also span from benchtop to bedside. In vitro studies complete the molecular imaging loop, by characterizing the relationship between FDG uptake, activation of prothrombotic cells, and expression of known prothrombotic gene products and effectors by these cells.

描述（由申请人提供）：血凝块形成、炎症和癌症之间的关联很强。癌症使患者容易出现血栓，这可能使治疗变得复杂，并且比非癌症患者的发病和死亡风险更高。匡威也是如此，近50%的患者谁开发无端静脉血栓栓塞性疾病（VTE）隐藏着一个隐匿性癌症，但在这些患者中寻找癌症并不被认为是标准的做法。当血凝块位于腹部或骨盆和/或患者对碘化造影剂有感染时，血凝块形成的诊断受到影响。在癌症患者中，与癌症或其治疗相关的多种解剖异常，以及腹腔内或盆腔凝块的倾向性增加，可能使VTE的诊断进一步复杂化。此外，目前还没有方法来识别癌症相关血栓形成风险特别高的患者，这是血栓预防的关键步骤。凝块、癌症和炎症之间的联系可能是由于宿主对癌症的反应导致局部和全身炎性细胞因子和组织因子的表达，这些细胞因子和组织因子作用于血小板和骨髓白细胞以产生最终导致血凝块形成的级联事件。FDG PET成像已成为恶性肿瘤诊断、分期和治疗评估的有力工具。基于初步的数据和个人观察，我们假设FDG PET可能是一个有用的辅助诊断复杂的情况下，静脉血栓栓塞，在识别患者的无端静脉血栓栓塞隐匿性恶性肿瘤，并确定系统状态，易患静脉血栓栓塞许多癌症患者。该项目的具体目标将在人类受试者中测试这些假设，并从台式到床边。体外研究通过表征FDG摄取、促血栓形成细胞的活化和这些细胞表达已知的促血栓形成基因产物和效应物之间的关系，完成了分子成像循环。