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目的探讨鼻咽癌Ki67表达与放疗前后SUVmax变化的关系。方法 (1)17只裸鼠鼻咽癌移植瘤模型随机分成对照组、6 Gy放疗组及12 Gy放疗组,各组在放疗前后进行18 F-FDG PET-CT显像,并于放疗结束后检测瘤体中Ki67表达的情况,对移植瘤的T/NT与Ki67表达水平变化进行分析;(2)12例初治鼻咽癌患者于放疗前、放疗50 Gy时及放疗结束后1周分别行18 F-FDG PET-CT显像,测定SUVmax;另外取其放疗前活检蜡块,用免疫组织化学方法检测组织中Ki67蛋白表达情况,分析Ki67表达与放疗前后SUVmax变化的关系。结果 (1)鼻咽癌移植瘤Ki67抗原的表达随放疗剂量的增加明显降低,不同组别间Ki67的表达差异有统计学意义(F=57.8,P<0.01);(2)不同组别间T/NT差异有统计学意义(F=14.0,P<0.01)。(3)初治鼻咽癌患者在放疗50Gy时,Ki67高表达的患者SUVmax水平明显低于低表达者,两者差异有统计学意义(t=2.235,P<0.05),而在放疗前(t=0.176,P>0.05)及放疗结束后则差异没有统计学意义(t=1.106,P>0.05)。结论 Ki67是影响鼻咽癌细胞FDG摄取的重要因素,放疗前Ki67的表达水平可能对放疗过程中鼻咽癌SUVmax的下降有重要影响。
Objective To investigate the relationship between the Ki67 expression in nasopharyngeal carcinoma and the changes of SUVmax before and after radiotherapy. Methods (1) 17 nude mice model of nasopharyngeal carcinoma were randomly divided into control group, 6 Gy radiotherapy group and 12 Gy radiotherapy group, and 18 F-FDG PET-CT imaging was performed before and after radiotherapy. At the end of radiotherapy Detecting the expression of Ki67 in the tumor, and analyzing the changes of T / NT and Ki67 in the transplanted tumor; (2) Twelve patients with nasopharyngeal carcinoma before radiotherapy, 50 Gy and one week after radiotherapy 18 F-FDG PET-CT imaging was performed to determine the SUVmax. In addition, pre-radiotherapy paraffin blocks were obtained. The expression of Ki67 protein in tissues was detected by immunohistochemistry. The relationship between Ki67 expression and the changes of SUVmax before and after radiotherapy was analyzed. Results (1) The expression of Ki67 antigen in nasopharyngeal carcinoma was significantly decreased with the increase of radiotherapy dose. The expression of Ki67 in different groups was significantly different (F = 57.8, P <0.01). (2) T / NT difference was statistically significant (F = 14.0, P <0.01). (3) The level of SUVmax in patients with newly diagnosed NPC was significantly lower than that in patients with low expression of Ki67 at 50 Gy of radiotherapy (t = 2.235, P <0.05) t = 0.176, P> 0.05) and there was no significant difference after radiotherapy (t = 1.106, P> 0.05). Conclusions Ki67 is an important factor affecting the uptake of FDG in nasopharyngeal carcinoma cells. The expression of Ki67 may play an important role in the decrease of SUVmax in nasopharyngeal carcinoma during radiotherapy.