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: 7672280
• 负责人: Kathryn Ann Morton
• 金额: $ 45.05万
• 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/7672280
• 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; Sensitivity and Specificity; Staging; Testing; Therapeutic; Thromboplastin; Thrombosis; base; cytokine; fluorodeoxyglucose positron emission tomography; high risk; 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性很强。癌症使患者容易形成血栓，这可能使治疗复杂化，并且比非癌症患者具有更高的发病和死亡风险。反之亦然，近 50% 的无端静脉血栓栓塞性疾病 (VTE) 患者患有隐匿性癌症，但在这些患者中寻找癌症并不被视为实践标准。当血栓位于腹部或骨盆和/或患者有碘造影剂禁忌症时，血栓形成的诊断就会受到影响。在癌症患者中，与癌症或其治疗相关的多种解剖异常，以及腹内或盆腔血栓的增加可能会使 VTE 的诊断进一步复杂化。此外，目前还没有方法可以识别癌症相关血栓形成风险特别高的患者，而癌症相关血栓形成是预防血栓的关键步骤。血凝块、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症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髓性白细胞，产生一系列事件，最终导致血凝块形成。 FDG PET 成像已成为恶性肿瘤诊断、分期和治疗评估的强大工具。根据初步数据和个人观察，我们假设 FDG PET 可能是诊断复杂 VTE 病例、识别患有隐匿性恶性肿瘤的无端 VTE 患者以及识别导致许多癌症患者易患 VTE 的全身状态的有用辅助手段。该项目的具体目标将在人类受试者中测试这些假设，并且范围涵盖从实验室到临床。体外研究通过表征 FDG 摄取、促血栓细胞激活以及这些细胞已知促血栓基因产物和效应子的表达之间的关系，完成了分子成像循环。