| Part one: The Preliminary Study of Hypoxic Prediction in Nasopharyn- geal Carcinoma Performed by 99mTc-EC-MN SPECT ScanningObjective:To investigated the feasibility and the security clinical value of hypoxic prediction in nasopharyngeal carcinoma performed by 99mTc-EC-MN SPECT scanning. To initially explore the clinical significance of 99mTc-EC-MN SPECT in tumor hypoxia imaging used by two ways. The first one was to evaluate the correlation between T/N (the radioactivity ratio of tumor to the normal tissues) and the age, gender, tumor staging and clinical staging of the patients, the other one was to search for the significance of 99mTc-EC-MN SPECT in predicting the prognosis of nasopharyngeal neoplasm by evaluating the association between the T/N and treatment response and the long therapeutic effect.Methods : Fifteen patients received 99mTc-EC-MN SPECT scanning before radiotherapy, and the ROI technique was adopted to measure the T/N. The fifteen patients received magnetic resonance imaging scanning after finishing the radiotherapy 3 to 4 weeks, then the therapeutic reaction rate was evaluated using the standard of World Health Organization. The follow-up results were collected. The last follow-up time was May, 2008. The 3-year overall survive rate, local control rate, and distant metastasis free rate were calculated using SPSS13.0.Results:There was no harmful reaction in all the patients receiving 99mTc-EC-MN SPECT. After injecting 99mTc-EC-MN for 3h ,the T/N values of all patients ranged from 0.91-3.51 (mean 2.14). There were no correlation between T/N and the age of patients, the gender, clinical staging, tumor staging. Eight of 15 patients were CR, and 7 patients were CR. The 3-year overall survive rate, local control rate, and distant metastasis free rate were 53.3%, 79.0%, and 86.2%, respectively. There were no significance in treatment responses, overall survive rate, local control rate, and distant metastasis free rate between T/N≤2.14 and T/N >2.14 group.Conclusions:99mTc-EC-MN SPECT scanning can be used safely to detect hypoxia in patients with nasopharyngeal carcinoma. The variation of T/N values among different tumors suggests that there exists hypoxic phenomenon in nasopharyngeal primary tumors. But its clinical value is inconclusive. Part two: Experimental study of the correlation between hypoxic image by SPECT and the expression of VEGF in tumor tissue of Lewis lung carcinomaObjective:To evaluate the correlation between T/M (the radioactivity ratio of tumor to the opposite muscle)by SPECT hypoxic image with 99mTc-EC-metronidazaole (99mTc-EC-MN) and the expression of vascular endothelial growth factor(VEGF) in Lewis lung cancer animal mode.Methods:EC-MN was labeled with 99mTc.12 mice bearing Lewis lung cancer were used for SPECT imaging and ROI technique was adopted to measure the T/M. Tumor biopsies were collected immediately after SPECT imaging. The expression of VEGF were detected by immunohistochemistry.Results:The T/M Value of Lewis lung sarcoma at 3h after injection of 99mTc-EC-MN ranges from 1.42 to 2.06 with mean value of 1.78±0.22.The expression of VEGF was 0.25%–2.05% with the median of 1.1%. There was a significant linear correlation between VEGF expression and T/M (t=2.557, P=0.0285).Conclusion:There is a correspondence between T/M value by SPECT and the expression of VEGF by immunohistochemistry.
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