[Value of 18F-FETNIM PET-CT for detection of tumor hypoxia in non-small-cell lung cancer].

OBJECTIVE: To assess the feasibility of [(18)F]fluoroerythronitroimidazole ((18)F-FETNIM) with integrated positron emission tomography and computed tomography (PET-CT) imaging in detection of hypoxia in non-small-cell lung cancer (NSCLC) patients. METHODS: Forty-two patients with newly diagnosed NSCLC underwent (18)F-FETNIM PET-CT before treatment. Nineteen patients rested for approximately 120 minutes before undergoing PET-CT, 23 patients underwent 2 sequential PET-CT scans at 60 minutes and 120 minutes after intravenous injection (18)F-FETNIM. (18)F-FETNIM uptake was quantified by calculating the maximum standardized uptake value in the tumor (SUVmax-T) and contralateral normal lung tissue (SUVmax-N). Regions of interest (ROIs) were drawn in the tumor and contralateral position and the radioactivity ratio of tumor to normal (T/N) was calculated. RESULTS: SUVmax-T (2.43 +/- 1.34) was significantly higher than SUVmax-N (0.87 +/- 0.46, P < 0.001) at 120 min. SUVmax-T (2.80 +/- 1.09) and SUVmax-N (1.16 +/- 0.56) at 60 min were significantly higher than SUVmax-T (2.61 +/- 1.10) and SUVmax-N (P < 0.01) at 120 min. T/N (2.56 +/- 0.71) at 60 min was higher than that at 120 min (2.48 +/- 0.60), but the difference between them was not significant (P = 0.324). CONCLUSION: Our results indicate that (18)F-FETNIM PET-CT may be a useful tool for evaluating hypoxia and may be a means to target specifically tumor cells resistant to conventional treatment before and during ongoing therapy in NSCLC.

[Evaluation of the diagnostic value of (18)F-FDG PET-CT and enhanced CT for staging of lymph node metastasis in non-small cell lung cancer].

OBJECTIVE: To evaluate the clinical value of (18)F-FDG PET-CT and enhanced CT imaging for staging of regional lymph node metastasis in non-small cell lung cancer (NSCLC) patients. METHODS: 122 patients with proven or suspected NSCLC underwent integrated PET-CT and enhanced CT scan before surgery. The results of lymph node metastasis diagnosed by PET-CT and CT were compared and analyzed according to the results of histopathological examination. RESULTS: PET-CT showed correctly lymph node staging in 80.3% of cases, overstaged in 13.1%, and understaged in 6.6%, while 55.8%, 26.2% and 18.0% by CT, respectively. The sensitivity, specificity, and accuracy of PET-CT for lymph node staging was 86.3%, 85.0% and 85.3%, respectively, while the corresponding data were 68.6%, 71.0% and 70.4% by CT, respectively (P < 0.01). 81.3% of false-negative and 71.6% false-positive lymph nodes by CT were interpreted correctly by PET-CT, while 57.1% of false-negative and 45.2% of false-positive lymph nodes by PET-CT were correctly diagnosed by CT. 5.9% of PET-CT-diagnosed negative lymph nodes were pathologically proven to be positive with small cancer foci and below 10 mm in diameter, while 8.2% of pathologically proven negative lymph nodes with inflammation, high FDG uptake and exceeding 10 mm (15 mm in subcarnial nodes) in diameter were false-positive on both PET-CT and CT imaging, therefore, these lymph nodes were still in the common blind area of diagnosis by both of PET-CT and CT. CONCLUSION: Compared with enhanced CT, integrated PET-CT improves the accuracy and is helpful to correct some CT-diagnosed false-positive and false-negative lymph nodes. But CT is also beneficial supplementation to PET-CT for assessment of regional lymph node metastasis. The combination of PET-CT and CT can make up the shortage of both of them in staging of regional lymph nodes in NSCLC patients.

[Correlation between FDG PET /CT and the expression of glutl and ki-67 antigen in esophageal cancer].

OBJECTIVE: To evaluate the correlation between standardized uptake valus (SUV) of 18F-fluorodeoxyglucose (18 F-FDG) of tumor at PET/CT examination and the expression of glucose transporter-1 (Glutl) and Ki-67 in esophageal cancer. METHODS: 56 patients with esophageal cancer were evaluated with 18 F-FDG PET/CT examination before operation. The expression of Glut1 and Ki-67 antigen in the tumor tissues was detected by immunohistochemistry after operation. RESULTS: (1) Positive rate of Glutl and Ki-67 expression in esophageal cancer tissues was 100% , respectively. There was a positive correlation between the expression of Glutl and Ki-67 and the clinical stages and differentiation of the tumor. The more the tumor and the clinical stages were advanced and the lower was the tumor differentiation, the more Glutl and Ki-67 were expressed. (2) There were abnormal radioactive high uptake regions on PET/CT imaging of esophagus in the 56 patients, which were confirmed by pathology as the primary carcinoma. The SUV was higher than 2. 5. There was a gradually increasing tendency in SUV along with the lowering of the tumor differentiation and the advance of clinical stages. (3)There was a correlation between the expression of Glutl, Ki-67 and the SUV, the more Glutl and Ki-67 were expressed, the higher the SUV of tumor 18F-FDG at PET/CT examination was in esophageal tumor tissues. CONCLUSION: There is a widespread expression of Glutl in esophageal cancer tissues, and the SUV may be used to indirectly evaluate the proliferative capacity of esophageal cancer.

[The effects of vascular endothelial growth factor on dendritic cells in esophageal tumor tissue].

AIM: To investigate the relationship between vascular endothelial growth factor (VEGF) and S100 protein positive dendritic cell (DC) in esophagelal tumor tissue. METHODS: VEGF and S100 protein in 94 patients with esophageal carcinoma were detected by HRP Labelled streptavidin biotin(LSAB) immunohistochemical method. RESULTS: Postive rate of VEGF in esophageal tumor tissues was 74.46%(70/94); and the later the clinical stage and the lower the differentiation level was the more VEGF was(r=0.864, 0.803, respectively; P<0.05); while the later the clinical stage and the lower the differentiation level was, the less number of S100(+) DCs existed (r=-0.763, -0.908, respectively; P<0.05). Furthermore, there was a reverse correlation between the expression of VEGF and S100(+) DC (r=-0.817, P<0.05). CONCLUSION: There may be a reverse relationship between the expression of VEGF and S100(+) DC in esophageal tumor tissue, VEGF could decrease the number of S100(+) DC and impair the immunological function of the body.

[Study of gastric function after esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds in patients with esophageal and cardiac cancer].

OBJECTIVE: To study the gastric function after esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds (VPRG)in patients with esophageal cancer (EC) and cardiac cancer (CC). METHODS: Sixty-eight patients with early or middle staged EC or CC received esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds (VPRG),while other 68 patients esophagectomy and cardiectomy with vagus nerve severed and no reconstruction of gastric funds (VSNG) as control. The symptoms,the pressure of the residual esophagus and thoracic stomach, 24-hour pH monitoring, mean basic gastric acid output, gastric emptying time of the intrathoracic stomach,fasting serum gastrin level, fibreoptic endoscopic results were compared before and after operation between the two groups. RESULTS: The patients with VPRG had less symptoms after operation than those with VSNG such as anorexia, belch, reflux, heartburn, nausea, diarrhea, postcibal satiety (P< 0.01). In VPRG group,compared with the results before operation,there were no significant differences in 24-hour pH monitoring,the mean basic gastric acid output, the fasting serum gastrin level,the gastric emptying time of intrathoracic stomach one month and one year after operation (both P > 0.05). The pressure of the residual esophagus above the anastomosis in VPRG group was significantly higher than that in VSNG group (both P< 0.05). Fibreoptic endoscopic examination revealed higher incidences of postoperative atrophic gastritis and reflux esophagitis in VPRG group one month and one year after operation than those in VSNG group (P< 0.01). CONCLUSION: Preservation of the vagus nerve and reconstruction of gastric funds after esophagectomy and cardiectomy for esophageal and cardiac cancer can prevent digestive disorder and improve the life quality of the patients.

[Expression of CD80, CD86, TGF-beta1 and IL-10 mRNA in the esophageal carcinoma].

OBJECTIVE: To investigate the correlation of CD80 and CD86 mRNA expression with the expression of transforming growth factor-beta1 mRNA (TGF-beta1) and interleukin-10 mRNA (IL-10) in the esophageal cancer. To explore the reason of impaired immunological function of dentritic cell (DC) and the mechanism of cancer cell escaption from body immunity system in the esophageal cancer patient. METHODS: Expression of CD80, CD86, TGF-beta1 and IL-10R mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR) in specimens of 62 esophageal carcinoma and 16 normal esophageal mucosal tissues used as normal control. RESULTS: Expression of CD80 and CD86 mRNA in the esophageal cancer tissue was significantly lower than that in the normal esophageal mucosal tissue (CD80: P = 0.038; CD86: P = 0.0002). It was significantly higher in stage I or II than that in stage III or IV (CD80: P = 0.029; CD86: P = 0.045); and also higher in paitents with high or moderate differentiation than that with poor differentiation (CD80: P = 0.046; CD86: P = 0.044). Furthermore, it was found to be reversely correlated with expression of TGF-beta1, IL-10 mRNA by multiple regression analysis (P = 0. 0001) respectively, the more TGF-beta1 and IL-10 mRNA expressed in the tumor tissue, the less CD80 and CD86 mRNA expressed by dendritic cells. CONCLUSION: The expression of CD80 and CD86 mRNA in the tissues of esophageal cancer are found to be weak, and reversely correlated with the expression of TGF-beta1 and IL-10 mRNA. High level expression of TGF-beta1 and IL-10 mRNA may be an important influential factor to the weak expression of CD80 and CD86 mRNA, which may be one of the reasons leading to impaired function of dendritic cells and immune escape of cancer cells in the esophageal cancer patient.

[Expression of CD1a, CD80, CD86 in dendritic cell of tumor tissue and regional lymph node in esophageal carcinoma].

BACKGROUND & OBJECTIVE: Dendritic cells are the important antigen presenting cell, and take part in the anti-tumor immunoreaction. This study was designed to investigate the expression of CD1a (specific marker) and CD80, CD86 (costimulating molecules) in dendritic cell of tumor tissue and regional lymph node of esophageal carcinoma and to investigate the mechanisms by which tumors escape immune recognition. METHODS: The expression of CD1a, CD80, CD86 in dendritic cells of tumor tissues and paratumor tissues from 58 patients with esophageal carcinoma (clinical period I-II:27 cases,III-IV: 31 cases;differentiation G(1-2): 37 cases,G3:21 cases;squamous cancer: 49 cases,adenoid cancer: 9 cases;lymph node metastases present: 37 cases,lymph node metastases absent: 21 cases), inflammatory tissues from 11 patients with esophagitis, 12 normal esophageal tissues (as control), 31 regional lymph nodes with tumor and 34 regional lymph nodes without tumor were determined using flow cytometry. RESULTS: (1) The expression rates of CD1a, CD80, CD86 in tumor tissues (6.18+/-1.47, 5.37+/-1.13, 37.35+/-7.42) were less than those in normal tissues (10.28+/-2.11, 9.67+/-1.94, 48.76+/-10.23), the inflammatory tissues (11.89+/-2.65, 10.46+/-1.79, 51.55+/-10.60), and the paratumor tissue (11.79+/-2.41, 10.49+/-1.89, 9.78+/-12.31) (P< 0.01). (2) The expression rates of CD1a, CD80, CD86 in regional lymph node with tumor (8.34+/-1.66,6.78+/-1.42,41.70+/-8.71) were less than those in the lymph node without tumor (12.23+/-2.14, 10.82+/-2.11, 59.63+/-12.52)(P< 0.01). (3) There was no significant difference in the expression rates of CD1a, CD80, CD86 between paratumor tissue, inflammatory tissue and normal esophageal tissues (P >0.05). (4) The expression of CD1a, CD80, CD86 were not associated with the clinical period, pathological type, and the lymph node metastases (P >0.05); but were associated with pathological differentiation (grade1-2 were higher than grade 3)(P< 0.01). CONCLUSION: (1) The number of dendritic cell of CD1a (+) decreases in tumor tissue and regional lymph node with tumor in esophageal carcinoma and the expression of CD80, CD86 are down-regulated. (2) The lower the tumor differentiation grade, the less the number of CD1a(+) dendritic cell in tumor tissue and regional lymph node and the lower the expression of CD80, CD86 in tumor tissue.