前列腺癌胆碱PET／CT显像与肿瘤分子生物学行为的相关性研究

摘要

目的：探讨前列腺癌PET／CT显像与其肿瘤分子生物学行为的相关性。方法共计26例于2007年4月至2010年3月接受11 C－胆碱PET／CT的前列腺癌患者纳入本项研究。测量前列腺癌肿瘤组织及肌肉组织的最高胆碱摄取值（SUVmax），并计算其比值（P／M）。同时以免疫组织化学方法检测肿瘤组织Ki－67、雄激素受体、CD31、Her－2／neu、PTEN和Bcl－2的表达情况，将其与胆碱摄取值的关系进行统计学分析。结果 SUVmax值平均为[9．42±6．70（1．69～24．65）]，SUVmax－P／M值平均为[4．33±1．41（1．18～7．44）]。26例患者以Ki－67标记增殖指数平均为[10．4±13．1（0～48）]，以CD31标记MVD平均为[26．4±11．8（7～48）]，AR半定量评分平均为[86．5±61．8（0～180）]。Spearman等级相关分析显示SUVmax－P／M值与增殖指数、MVD值均具有统计学相关性。26例患者中判定为Her－2／neu、Bcl－2及PTEN表达阳性的患者分别为6例，13例及11例。其中Her－2／neu表达阳性的患者SUVmax－P／M值明显高于阴性的患者，具有统计学差异。结论以同层肌肉SUVmax值校正后的前列腺癌病灶胆碱摄取值SUVmax－P／M值能较好反映前列腺癌的肿瘤生物学行为，具有很高的临床应用价值。%Objective To investigate the association of choline uptake index of prostate cancer PET/CT im-age with molecular biological behaviour. Methods Twenty -six patients with diagnosis of prostate cancer be-tween April 2007 and March 2010 at our center were included in this study. The SUVmax (standard uptake val-ue)of the prostate cancer and the pelvic muscles were measured and their ratios (P/M)were calculated. Using Envision immunohistochemistry,several biomarkers of molecular biology,including Ki-67,androgen receptor, CD31,Her-2eu,Bcl-2 and PTEN expressions were examined. Statistical analysis on the relationship be-tween uptake of the prostate cancer and expression levels of molecular biomarkers were performed. Results The mean value of SUVmax of the primary tumors was (9 . 42 ± 6 . 70 )(ranged from 1 . 69 to 24 . 65 ),whereas the mean SUVmax-P/M ratios was(4. 33 ± 1. 41)(ranged from 1. 18 to 7. 44). The mean value of Ki-67 labe-ling index and androgen receptor index was (10 . 4 ± 13 . 1 )(ranged from 0 to 48 )and (86 . 5 ± 61 . 8 )(ranged from 0 to 180 ). The mean rate of MVD as assessed by CD31 was (26 . 4 ± 11 . 8 )(ranged from 7 to 48 ). Posi-tive expression of Her-2eu,Bcl-2 and PTEN was recognized in 6,13,and 11 patients,respectively. The correlation coefficients for SUVmax-P/M ratio with Ki-67 and MVD were 0 . 503 and 0 . 545 ,and the P values for both of these two biomarkers correlations were <0 . 05 . SUVmax-P/M raito was higher in Her-2eu posi-tive subgroup than negative subgroup. Conclusions This pilot study indicate that the 11C -Choline uptake in primary prostate cancer normalized by pelvic muscle does correlate with expression of several tumoral biomark-ers. These findings confirm that PET/CT could be used as a non-invasive diagnostic modality that can provide information currently available only through pathological examination of tumor tissues.