胰腺癌18 F-FDG摄取程度与血管内皮生长因子及微血管密度的关系

摘要

Objective To preliminarily investigate the relationship between 18 F-FDG uptake and VEGF as well as MVD in resected specimens of pancreatic cancer, and to find out whether 18 F-FDG uptake can assess tumor angiogenesis in vivo. Method From May 2008 to September 2011, 10 patients with resected pancreatic ductal adenocarcinoma, who had underg-one preoperative 18 F-FDG PET-CT scan without prior chemotherapy or radiotherapy, were enrolled in this study. The PET-CT data was used to calculate tumor maximum SUV (SUVmax). With resected tumor specimens, VEGF and intratumoral MVD expression level were assessed using immunohistochemical staining. Result In the 10 patients included in the study, the median SUVmax was 4. 7 (3. 3~5. 9), and median MVD was 67 (49~110). Four patients had VEGF (-), 3 had VEGF (+) and 3 had VEGF (++). Setting median SUVmax=4. 7 as the cut-off value for grouping, we found that patients with VEGF (++) had higher SUVmax than those with VEGF (+) / (-), and higher MVD was likely correlated to increased SUVmax . Conclusion The small sample research of 10 patients indicates that in patients with pancreatic ductal adenocarcino-ma, higher SUVmax of primary tumor suggests more likely occurrence of metastases. There is a possible tendency of positive correlation between SUVmax and VEGF, as well as MVD. The preliminary results suggest that 18 F-FDG PET-CT may be ap-plied to assess the angiogenesis in vivo and offer more valuable information for clinical molecular-targeted therapy.%目的：初步探讨胰腺癌病灶的18 F-FDG摄取程度( SUV)与手术切除标本的血管内皮生长因子( VEGF)表达及微血管密度( MVD)之间的关系，考察SUV是否能够于疗前在体评估胰腺癌的血管生成状态。方法纳入2008年5月至2011年9月于我科行PET-CT检查后行手术切除的10例胰腺导管腺癌患者，术前均未行放疗或化疗。记录PET-CT图像中病灶的最大标准摄取值( SUVmax )，并使用免疫组织化学染色检查胰腺癌标本的MVD及VEGF表达。结果10例胰腺癌病灶的中位SUVmax为4．7(3．3~5．9)，中位 MVD为67(49~110)， VEGF (-)4例， VEGF (+)3例， VEGF (++)3例。取中位SUVmax=4．7为界值点分组对比可知， VEGF (++)患者的SUVmax高于VEGF (+)/(-)患者，且MVD计数较高与SUVmax偏高存在一定正相关趋势。结论本组小样本结果初步表明，胰腺导管腺癌的SUVmax越高，发生转移的可能性越大。 SUVmax与VEGF表达和MVD计数存在正相关趋势的可能，初步提示18 F-FDG PET-CT检查有可能于疗前在体评估胰腺癌的血管生成状态，有望为临床是否行分子靶向治疗提供更多有价值的信息。