Detection of somatostatin receptor subtypes 2 and 5 by somatostatin receptor scintigraphy and immunohistochemistry: Clinical implications in the diagnostic and therapeutic management of gastroenteropancreatic neuroendocrine tumors

Tumori - Tập 97 Số 5 - Trang 620-628 - 2011
Francesco Sclafani1, Carlo Carnaghi1, Luca Di Tommaso2, Marcello Rodari3, Annarita Destro2, Lorenza Rimassa1, Laura Giordano4, Arturo Chiti3, Massimo Roncalli2, Armando Santoro1
1Medical Oncology and Hematology Unit, Humanitas Cancer Center, Istituto Clinico Humanitas, IRCCS, Rozzano (MI), Italy
2Pathology Department, Humanitas Cancer Center, Istituto Clinico Humanitas, IRCCS, Rozzano (MI), Italy
3Nuclear Medicine Department, Humanitas Cancer Center, Istituto Clinico Humanitas, IRCCS, Rozzano (MI), Italy
4Statistics Unit, Humanitas Cancer Center, Istituto Clinico Humanitas, IRCCS, Rozzano (MI), Italy

Tóm tắt

Aims and background Somatostatin receptor scintigraphy (SRS) is the standard method for the detection of somatostatin receptors (SSTRs). It is commonly used in gastroenteropancreatic neuroendocrine tumor (GEP-NET) staging, and represents the criterion of choice for treatment with somatostatin (SST) analogs. Immunohistochemistry (IHC) was reported as a reliable method for the detection of SSTRs with theoretically superior sensitivity over SRS. Methods and study design We retrospectively analyzed the sensitivity and specificity of IHC in the detection of SSTRs in a cohort of consecutive patients with GEP-NETs attending our Institute from 1997 to 2007. IHC analysis was restricted to SSTR2 and SSTR5, and the results were interpreted according to two different scoring systems. SRS was used as the gold standard. Results Forty-four patients were enrolled; 24 (55%) had foregut carcinoids, 9 (20%) midgut carcinoids, 2 (5%) hindgut carcinoids, and 9 (20%) had GEP-NETs of unknown primary sites. A high concordance rate between IHC and SRS was shown, irrespective of the IHC scoring system applied (73% and 70%). The sensitivity of IHC was 89.3% and 78.6% and the specificity 43.8% and 50%, depending on the scoring system used. Conclusions Although SSTR2 was shown to be expressed by IHC in up to 50% of tumors not visualized by SRS, SRS still remains the method of choice in the diagnostic and therapeutic management of GEP-NETs. More pathological and clinical data are needed to properly understand the clinical relevance of immunohistochemical detection of SSTR expression in the absence of tumor uptake at SRS.

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Tài liệu tham khảo

10.1073/pnas.89.1.251

Yamada Y., 1992, Mol Endocrinol, 6, 2136

10.1006/bbrc.1993.2122

10.1007/s00428-002-0609-x

10.1172/JCI117090

Janson E.T., 1996, Cancer Res, 56, 2561

Janson E.T., 1998, Cancer Res, 58, 2375

10.1136/gut.38.1.33

10.1210/edrv-12-4-450

Hofland L.J., 2003, J Nucl Med, 44, 1315

10.1093/annonc/mdh216

10.1080/02841860701441848

10.1007/s002590050034

10.1530/eje.0.1310577

Chiti A., 2000, Q J Nucl Med, 44, 42

Lebtahi R., 1997, J Nucl Med, 38, 853

10.1136/gut.50.1.52

10.1200/JCO.2007.12.7431

Lamberts S.W.J., 1994, Semin Oncol, 21, 1

Krenning E.P., 1994, Semin Oncol, 21, 6

Gabriel M., 2003, J Nucl Med, 44, 708

10.1038/modpathol.3800954

Solcia E., 2000, WHO international histological classification of tumors, 2, 61

Kimura N., 1999, Clin Cancer Res, 5, 3483

10.1016/S0002-9440(10)65564-2

10.1023/A:1014972520302

10.1007/s004280100494

10.1210/er.2000-0001

10.1055/s-0029-1211980

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Tumori

Tập 97 Số 5

620-628

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