肝癌患者99mTc-MIBI显像与肝癌组织中P糖蛋白的表达关系

Correlation of 99mTc-methoxyisobutyl isonitrile images with expression of P-glycoprotein in patients with hepatocellular carcinoma

目的 探讨患者肝癌组织中P-糖蛋白（Pgp）表达水平与术前99mTc-MIBI显像的关系.方法 78例原发性肝癌患者行99mTc-甲氧基异丁基异腈（MIBI）单光子发射计算机断层显像（sPECT）检测,经外周静脉注射20 mCi 99mTc-MIBI后15min和120min行平面显像半定量分析肿物部位的摄取比值.应用RT-PCR和免疫组化方法分别检测手术标本中P糖蛋白的mRNA和蛋白表达水平.结果 99mTc-MIBI SPECT检查,78例患者中68例肿瘤区域无99mTc-MIBI 摄取（87.2%）;所有无99mTc-MIBI 摄取者其肿瘤区域均表达Pgp（P〈0.017）.结论 术前99mTc-MIBI SPECT检查可以预测肝癌组织Pgp表达水平.

Objective To explore the relationship between P- glycoprotein （Pgp）expression in hepatocellular carcinoma tissues and the images of 99roTe -methoxyisobutyl isonitrile （MIBI）prior to the operation in patients with liver cancer. Methods 99mTc - MIBI imaging was performed in 78 liver cancer patients 15 and 120 min after injection of 20 mCi 99mTc - MIBI,respectively. Early uptake,delayed uptake （L/Nd） and washout rate（L/Nwr） of 99mTc - MIBI were obtained. The immunohistochemical expressions of the Pgp in these tumor tissues were detected. Pgp mRNA expression was also measured by the real - time polymerase chain reaction（ RT - PCR）method. Results 99mTc - MIBI imaging revealed no 99mTc - MIBI uptakes in tumor lesions of 68 patients（68/78,87.2% ）. P - gp expression was also detected in tumor tissues of the patients with no uptake of 99mTc - MIBI（ P 〈 0. 017 ）. Conclusion 99mTC - MIBI imaging is a noninvasive and useful method that can be used to detect the presence of MDR1 gent - encoded Pgp in patients with hepatocellular carcinoma.