肿瘤组织乏氧与葡萄糖代谢

Hypoxia and glycometabolism in cancer tissue

  • 摘要: 乏氧是导致放、化疗失败原因之一,活体探知葡萄糖和乏氧代谢空间分布,有助于修订放疗计划以提高治疗效果、早期评估患者放化疗疗效和预后。18F-氟脱氧葡萄糖(18F-FDG)沉积主要依赖血流供应,与细胞摄取率关系较弱,且仅反映肿瘤细胞膜葡萄糖通量大小,无法区分有氧代谢、细胞增殖旺盛组织和乏氧组织。临床经验提示,18F-FDG综合反映肿瘤恶性程度,且葡萄糖代谢和乏氧代谢空间分布差异大者肿瘤侵袭性较强。18F-FDG和18F-氟米索硝唑的摄取总体相仿,但不能除外局部差异。目前的研究结果并不能完全否认18F-FDG可作为乏氧标志物使用,但其评估肿瘤乏氧状态的价值或特异性有限。

     

    Abstract: The resistant of hypoxia tumor cell to radiotherapy and chemotherapy is one of the reasons that lead to therapy failure. To detect the distribution difference of hypoxia and glycometabolism in vivo is helpful to revise radiotherapy plan in order to improve the therapeutic effect, or to evaluate the prognosis shortly after radiotherapy and chemotherapy. TTie deposition of 18F-fluorodeoxyglucose (18F-FDG) mainly depends on blood flow with weak relation to uptake rate, and only reflects the membrane flux of glucose without distinguishing aerobic metabolism, enhanced cell proliferation and hypoxia tissue. Clinical experience indicated that 18F-FDG could integratedly reflect the malignant degree of tumor for the more difference between the distribution of hypoxia and glycometabolism, the more invasion of the tumor. The distribution of 18F-FDG and 18F-fluoromisonidazole were similar in general, but can not exclude minor deference. Current studies can not deny 18F-FDG as a hypoxia agent with a limited value and specificity.

     

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