胆囊神经内分泌瘤和177 Lu DOTATATE:高索马托斯塔丁受体表达没有临床反应
Mehmet Aksakal1, Yongjun Liu2, Delphine L Chen1
1Departments of Radiology.
Clinical nuclear medicine
|June 5, 2025
概括
胆囊神经内分泌瘤 (GB-NETs) 是罕见的. 尽管体静止素受体成像吸收率很高,但lutetium-177DOTATATE治疗未能控制GB-NET患者的转移.
科学领域:
- 在瘤学瘤学.
- 核医学是一种核医学.
- 胃肠病学 胃肠病学
背景情况:
- 胆囊神经内分泌瘤 (GB-NETs) 是神经内分泌瘤的一个罕见子集,占所有病例的0.5%以下.
- 关于GB-NETs中体静止素受体 (SSTR) 表达和它们对像Lutetium-177 (177Lu) DOTATATE这样的SSTR向药物的治疗反应的数据有限.
- -68 (68Ga) DOTATATE正子发射断层扫描/计算机断层扫描 (PET/CT) 对于评估SSTR表达和指导177Lu DOTATATE治疗策略至关重要.
研究的目的:
- 报告一个患有晚期胆囊神经内分泌瘤的患者的临床病例.
- 为了研究在患有胆囊神经内分泌瘤的患者中,尽管索马托斯塔丁受体成像呈阳性,但Lutetium-177 DOTATATE治疗的疗效.
- 为了突出胆囊神经内分泌瘤中体静止素受体成像和治疗反应之间的潜在不一致.
主要方法:
- 一名74岁的男性患者的病例介绍,诊断出患有WHO第3级胆囊神经内分泌瘤的病例.
- 使用68Ga DOTATATE PET/CT进行体静止素受体表达和治疗计划的成像.
- 用于治疗转移性疾病的卢-177 (177Lu) DOTATATE 治疗.
主要成果:
- 这位患者出现了复发的世卫组织3级胆囊神经内分泌瘤,肝转移.
- -68 DOTATATE PET/CT在转移性病变中显示出高吸收率,这表明索马托斯塔丁受体的表达.
- 尽管索马托斯塔丁受体吸收率高,并接受了177LuDOTATATE治疗,但仍观察到肝转移的进展,导致治疗中止.
结论:
- 在胆囊神经内分泌瘤中,阳性索马托斯塔丁受体成像并不总是预测对Lutetium-177 DOTATATE治疗的良好反应.
- 这一案例强调了在SSTR向放射性核素治疗罕见神经内分泌瘤期间仔细选择和监测患者的重要性.
- 需要进一步的研究,以了解胆囊神经内分泌瘤治疗耐药性的机制,尽管SSTR表达.
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