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原发性中枢神经系统恶性肿瘤是导致40岁以下男性、20岁以下女性及儿童死亡的主要病因之一 [1]。脑胶质瘤作为最常见的原发性中枢神经系统恶性肿瘤之一,占所有原发性中枢神经系统恶性肿瘤的80%以上,年发病率为3~6.4/10万[2]。
脑胶质瘤起源于脑胶质细胞,WHO根据细胞类型(星形胶质细胞、室管膜细胞、少突胶质细胞)、肿瘤侵袭性和异型性将脑胶质瘤等级分为Ⅰ ~Ⅳ级[3],其中Ⅰ 、Ⅱ级为低级别脑胶质瘤,Ⅲ 、Ⅳ级为高级别脑胶质瘤。脑胶质瘤最常见的组织病理学类型是多形性胶质母细胞瘤(glioblastoma multiforme,GBM),约占所有类型脑胶质瘤的51%,也是级别最高的脑胶质瘤(Ⅳ级)[4]。脑胶质瘤具有增殖、侵袭、对传统的放化疗有抵抗性等特征,会导致患者在数月或数年内死亡[5]。脑胶质瘤的手术及非手术治疗反应评估对最佳治疗策略的选择至关重要,特别是对治疗失败的及时识别可及早终止无效治疗并避免不良反应如骨髓抑制、乏力、恶心、呕吐等情况的发生,有助于提高患者的生存率和生活质量[6]。
基于精氨酸-甘氨酸-天冬氨酸(arginine-glycine-aspartic acid,RGD)序列的小分子多肽可与新生血管活化内皮细胞表面高表达的整合素αvβ3特异性结合[7],因此放射性核素标记RGD肽作为示踪剂的PET显像可以显示整合素αvβ3在肿瘤内尤其是在脑胶质瘤中的分布[8]。RGD PET显像对脑胶质瘤的诊断、鉴别诊断及疗效评估已得到广泛研究。基于此,我们对RGD PET显像在脑胶质瘤临床应用中的研究进展进行综述,并探讨其挑战和机遇。
RGD肽类示踪剂及其PET显像在脑胶质瘤诊疗中的应用
RGD peptide tracers and their PET imaging in the diagnosis and treatment of glioma
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摘要: 细胞黏附因子整合素αvβ3在包括脑胶质瘤在内的多种肿瘤新生血管内皮细胞及细胞表面高表达,而在正常细胞表面低表达或不表达。精氨酸-甘氨酸-天冬氨酸(RGD)肽可特异性结合整合素αvβ3。放射性核素标记的RGD肽已成为脑胶质瘤靶向显像的研究热点,RGD PET显像在脑胶质瘤诊断和疗效监测中有一定的价值。基于此,笔者对RGD PET显像在脑胶质瘤诊疗中的应用进行综述。
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关键词:
- 脑肿瘤 /
- 神经胶质瘤 /
- 整合素αvβ3 /
- 正电子发射断层显像术 /
- 精氨酸-甘氨酸-天冬氨酸
Abstract: Cell adhesion factor integrin αvβ3 is highly expressed in the surface of neovascularization endothelial cells and cells of many kinds of tumors, including gliomas, while it is low or not expressed in the surface of normal cells. Arginine-glycine-aspartic acid (RGD) peptides can specifically bind to integrin αvβ3. Radionuclide-labeled RGD peptide has become the research focus of targeted imaging of glioma. RGD PET imaging has certain value in the diagnosis and curative effect monitoring of glioma. Based on this, this article reviews the application of RGD PET imaging in the diagnosis and treatment of glioma.-
Key words:
- Brain neoplasms /
- Glioma /
- Integrin αvβ3 /
- Positron-emission tomography /
- Arginine-glyeine-aspartie acid
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[1] Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2022[J]. CA Cancer J Clin, 2022, 72(1): 7−33. DOI: 10.3322/caac.21708. [2] 李德培, 陈忠平. 脑胶质瘤治疗现状与进展[J]. 实用医学杂志, 2021, 37(18): 2312−2316. DOI: 10.3969/j.issn.1006-5725.2021.18.002.
Li DP, Chen ZP. Current statue and advances of treatment for gliomas[J]. J Pract Med, 2021, 37(18): 2312−2316. DOI: 10.3969/j.issn.1006-5725.2021.18.002.[3] Guo H, Liu J, Hu JJ, et al. Diagnostic performance of gliomas grading and IDH status decoding a comparison between 3D amide proton transfer APT and four diffusion-weighted MRI models[J]. J Magn Reson Imaging, 2022, 56(6): 1834−1844. DOI: 10.1002/jmri.28211. [4] Wesseling P, Capper D. WHO 2016 classification of gliomas[J]. Neuropathol Appl Neurobiol, 2018, 44(2): 139−150. DOI: 10.1111/nan.12432. [5] Burko P, D'Amico G, Miltykh I, et al. Molecular pathways implicated in radioresistance of glioblastoma multiforme: what is the role of extracellular vesicles?[J/OL]. Int J Mol Sci, 2023, 24(5): 4883[2022-07-12]. https://www.mdpi.com/1422-0067/24/5/4883. DOI: 10.3390/ijms24054883. [6] Langen KJ, Heinzel A, Lohmann P, et al. Advantages and limitations of amino acid PET for tracking therapy response in glioma patients[J]. Expert Rev Neurother, 2020, 20(2): 137−146. DOI: 10.1080/14737175.2020.1704256. [7] Ebenhan T, Kleynhans J, Zeevaart JR, et al. Non-oncological applications of RGD-based single-photon emission tomography and positron emission tomography agents[J]. Eur J Nucl Med Mol Imaging, 2021, 48(5): 1414−1433. DOI: 10.1007/s00259-020-04975-9. [8] Cai HC, Conti PS. RGD-based PET tracers for imaging receptor integrin αvβ3 expression[J]. J Labelled Comp Radiopharm, 2013, 56(5): 264−279. DOI: 10.1002/jlcr.2999. [9] Li XR, Sun XD, Carmeliet P. Hallmarks of endothelial cell metabolism in health and disease[J]. Cell Metab, 2019, 30(3): 414−433. DOI: 10.1016/j.cmet.2019.08.011. [10] Aman J, Margadant C. Integrin-dependent cell-matrix adhesion in endothelial health and disease[J]. Circ Res, 2023, 132(3): 355−378. DOI: 10.1161/CIRCRESAHA.122.322332. [11] Mezu-Ndubuisi OJ, Maheshwari A. The role of integrins in inflammation and angiogenesis[J]. Pediatr Res, 2021, 89(7): 1619−1626. DOI: 10.1038/s41390-020-01177-9. [12] Pang XC, He X, Qiu ZW, et al. Targeting integrin pathways: mechanisms and advances in therapy[J]. Signal Transduct Target Ther, 2023, 8(1): 1. DOI: 10.1038/s41392-022-01259-6. [13] Peix F, Casanovas O. Promalignant effects of antiangiogenics in the tumor microenvironment[J]. Semin Cancer Biol, 2022, 86(Pt 3): 199−206. DOI: 10.1016/j.semcancer.2022.03.003. [14] Slack RJ, Macdonald SJF, Roper JA, et al. Emerging therapeutic opportunities for integrin inhibitors[J]. Nat Rev Drug Discov, 2022, 21(1): 60−78. DOI: 10.1038/s41573-021-00284-4. [15] Cheng TM, Chang WJ, Chu HY, et al. Nano-strategies targeting the integrin αvβ3 network for cancer therapy[J/OL]. Cells, 2021, 10(7): 1684[2022-07-12]. https://www.mdpi.com/2073-4409/10/7/1684. DOI: 10.3390/cells10071684. [16] Nieberler M, Reuning U, Reichart F, et al. Exploring the role of RGD-recognizing integrins in cancer[J/OL]. Cancers (Basel), 2017, 9(9): 116[2022-07-12]. https://www.mdpi.com/2072-6694/9/9/116. DOI: 10.3390/cancers9090116. [17] Liolios C, Sachpekidis C, Kolocouris A, et al. PET diagnostic molecules utilizing multimeric cyclic RGD peptide analogs for imaging integrin αvβ3 receptors[J/OL]. Molecules, 2021, 26(6): 1792[2022-07-12]. https://www.mdpi.com/1420-3049/26/6/1792. DOI: 10.3390/molecules26061792. [18] Haubner R, Kuhnast B, Mang C, et al. [18F]Galacto-RGD: synthesis, radiolabeling, metabolic stability, and radiation dose estimates[J]. Bioconjug Chem, 2004, 15(1): 61−69. DOI: 10.1021/bc034170n. [19] Isal S, Pierson J, Imbert L, et al. PET imaging of 68Ga-NODAGA-RGD, as compared with 18F-fluorodeoxyglucose, in experimental rodent models of engrafted glioblastoma[J/OL]. EJNMMI Res, 2018, 8(1): 51[2022-07-12]. https://ejnmmires.springeropen.com/articles/10.1186/s13550-018-0405-5. DOI: 10.1186/s13550-018-0405-5. [20] Oxboel J, Brandt-Larsen M, Schjoeth-Eskesen C, et al. Comparison of two new angiogenesis PET tracers 68Ga-NODAGA-E[c(RGDyK)]2 and 64Cu-NODAGA-E[c(RGDyK)]2; in vivo imaging studies in human xenograft tumors[J]. Nucl Med Biol, 2014, 41(3): 259−267. DOI: 10.1016/j.nucmedbio.2013.12.003. [21] Pohle K, Notni J, Bussemer J, et al. 68Ga-NODAGA-RGD is a suitable substitute for 18F-Galacto-RGD and can be produced with high specific activity in a cGMP/GRP compliant automated process[J]. Nucl Med Biol, 2012, 39(6): 777−784. DOI: 10.1016/j.nucmedbio.2012.02.006. [22] Delgado-López PD, Riñones-Mena E, Corrales-García EM. Treatment-related changes in glioblastoma: a review on the controversies in response assessment criteria and the concepts of true progression, pseudoprogression, pseudoresponse and radionecrosis[J]. Clin Transl Oncol, 2018, 20(8): 939−953. DOI: 10.1007/s12094-017-1816-x. [23] Schnell O, Krebs B, Carlsen J, et al. Imaging of integrin αvβ3 expression in patients with malignant glioma by [18F] galacto-RGD positron emission tomography[J]. Neuro Oncol, 2009, 11(6): 861−870. DOI: 10.1215/15228517-2009-024. [24] Iagaru A, Mosci C, Mittra E, et al. Glioblastoma multiforme recurrence: an exploratory study of 18F FPPRGD2 PET/CT[J]. Radiology, 2016, 280(1): 328. DOI: 10.1148/radiol.2016164020. [25] Li DL, Zhao XB, Zhang LW, et al. 68Ga-PRGD2 PET/CT in the evaluation of glioma: a prospective study[J]. Mol Pharm, 2014, 11(11): 3923−3929. DOI: 10.1021/mp5003224. [26] Li DL, Zhang JJ, Ji N, et al. Combined 68Ga-NOTA-PRGD2 and 18F-FDG PET/CT can discriminate uncommon meningioma mimicking high-grade glioma[J]. Clin Nucl Med, 2018, 43(9): 648−654. DOI: 10.1097/RLU.0000000000002233. [27] Guo JX, Guo N, Lang LX, et al. 18F-alfatide Ⅱ and 18F-FDG dual-tracer dynamic PET for parametric, early prediction of tumor response to therapy[J]. J Nucl Med, 2014, 55(1): 154−160. DOI: 10.2967/jnumed.113.122069. [28] Battle MR, Goggi JL, Allen L, et al. Monitoring tumor response to antiangiogenic sunitinib therapy with 18F-fluciclatide, an 18F-labeled αVβ3-integrin and αVβ5-integrin imaging agent[J]. J Nucl Med, 2011, 52(3): 424−430. DOI: 10.2967/jnumed.110.077479. [29] Provost C, Prignon A, Rozenblum-Beddok L, et al. Comparison and evaluation of two RGD peptides labelled with 68Ga or 18F for PET imaging of angiogenesis in animal models of human glioblastoma or lung carcinoma[J/OL]. Oncotarget, 2018, 9(27): 19307−19316[2022-07-12]. https://www.oncotarget.com/article/25028/text/. DOI: 10.18632/oncotarget.25028. [30] 宋双双, 王振光. 氨基酸类PET联合MRI在脑胶质瘤诊疗中的应用[J]. 中华神经医学杂志, 2022, 21(11): 1164−1167. DOI: 10.3760/cma.j.cn115354-20220531-00379.
Song SS, Wang ZG. Recent advance in amino acid PET combined with MRI in brain gliomas[J]. Chin J Neuromed, 2022, 21(11): 1164−1167. DOI: 10.3760/cma.j.cn115354-20220531-00379.[31] Weller M. Novel diagnostic and therapeutic approaches to malignant glioma[J]. Swiss Med Wkly, 2011, 141: w13210. DOI: 10.4414/smw.2011.13210. [32] Quartuccio N, Laudicella R, Vento A, et al. The additional value of 18F-FDG PET and MRI in patients with glioma: a review of the literature from 2015 to 2020[J/OL]. Diagnostics (Basel), 2020, 10(6): 357[2022-07-12]. https://www.mdpi.com/2075-4418/10/6/357. DOI: 10.3390/diagnostics10060357. [33] Zhang H, Liu N, Gao S, et al. Can an 18F-ALF-NOTA-PRGD2 PET/CT scan predict treatment sensitivity to concurrent chemoradiotherapy in patients with newly diagnosed glioblastoma?[J]. J Nucl Med, 2016, 57(4): 524−529. DOI: 10.2967/jnumed.115.165514. [34] Mohtavinejad N, Ardestani MS, Khalaj A, et al. Application of radiolabeled peptides in tumor imaging and therapy[J]. Life Sci, 2020, 258: 118206. DOI: 10.1016/j.lfs.2020.118206. [35] Bozon-Petitprin A, Bacot S, Gauchez AS, et al. Targeted radionuclide therapy with RAFT-RGD radiolabelled with 90Y or 177Lu in a mouse model of αvβ3-expressing tumours[J]. Eur J Nucl Med Mol Imaging, 2015, 42(2): 252−263. DOI: 10.1007/s00259-014-2891-7. [36] Liu ZF, Shi JY, Jia B, et al. Two 90Y-labeled multimeric RGD peptides RGD4 and 3PRGD2 for integrin targeted radionuclide therapy[J]. Mol Pharm, 2011, 8(2): 591−599. DOI: 10.1021/mp100403y. [37] Shi JY, Fan D, Dong CY, et al. Anti-tumor effect of integrin targeted 177Lu-3PRGD2 and combined therapy with Endostar[J/OL]. Theranostics, 2014, 4(3): 256−266[2022-07-12]. https://www.thno.org/v04p0256.htm. DOI: 10.7150/thno.7781. [38] Jin ZH, Furukawa T, Degardin M, et al. αVβ3 integrin-targeted radionuclide therapy with 64Cu-cyclam-RAFT-c(-RGDfK-)4[J]. Mol Cancer Ther, 2016, 15(9): 2076−2085. DOI: 10.1158/1535-7163.MCT-16-0040.
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