F H Schilling, H Bihl, H Jacobsson, P F Ambros, T Martinsson, P Borgström, K Schwarz, I M Ambros, J Treuner, P Kogner
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引用次数: 48
摘要
背景:高亲和力生长抑素受体(SRs)在神经母细胞瘤中已被证实，并可作为体内检测sr的靶结构。方法:88例经组织学证实的神经母细胞瘤患儿在诊断或复发时采用(123)I-mIBG和(111)in - pentreotide显像进行了研究。对所有肿瘤进行MYCN拷贝数、染色体1p36状态和DNA含量68/88的调查，中位随访时间为35个月(范围1-88个月)。结果:56/88例肿瘤中有SR表达，123例肿瘤中有I-mIBG阳性。(111) in - penteotide检测肿瘤组织的敏感性低于(123)I-mIBG (64% vs. 94%， P = 0.005)。根据Kaplan-Meier的生存率(SUR)和无事件生存率(EFS)， SR扫描呈阳性的儿童明显优于SR扫描呈阴性的儿童(4年生存率:90% vs 48%， log rank P < 0.003; 4年生存率:83% vs 39%， log rank P < 0.0002)。结论:(123)I-mIBG显像仍然是检测神经母细胞瘤肿瘤组织的最佳显像方法，而额外的SR显像能够以最小的侵入性提供重要的预后信息。
Combined (111)In-pentetreotide scintigraphy and (123)I-mIBG scintigraphy in neuroblastoma provides prognostic information.
Background: High-affinity somatostatin receptors (SRs) have been characterized in neuroblastomas and may be used as target structures for in vivo detection of SR.
Procedure: Eighty-eight children with histologically proven neuroblastoma were investigated at diagnosis or relapse by (123)I-mIBG and (111)In-pentetreotide scintigraphy. All tumors were investigated for MYCN copy number, chromosome 1p36 status, and 68/88 also for DNA content, followed for a median follow-up of 35 months (range 1-88 months).
Results: SR expression was detected in 56/88 tumors and (123)I-mIBG showed positivity in 83/88. (111)In-pentetreotide was less sensitive in detecting tumor tissue than was (123)I-mIBG (64% vs. 94%, P = 0.005). Survival (SUR) and event-free survival probability (EFS) according to Kaplan-Meier was significantly better for children with positive SR scintigraphy than for the children with a negative SR scan (SUR: 90% vs. 48% at 4 years log rank P < 0.003, EFS: 83% vs. 39% at 4 years, log rank P < 0.0002).
Conclusions: (123)I-mIBG scintigraphy remains the best scintigraphic method for detecting neuroblastoma tumor tissue, whereas additional SR scintigraphy is able to provide significant prognostic information with a minimum of invasiveness.
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