Page 150 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第42卷第2期
·296 · Journal of Nanjing Medical University（Natural Sciences） 2022年2月

·综 述·

儿童难治性神经母细胞瘤核素诊疗一体化研究进展

张晓军 ，王 峰 2*
1
南京医科大学附属儿童医院影像中心，江苏 南京 210008；南京医科大学附属南京第一医院核医学科，江苏 南京
1 2
210006

［摘 要］ 神经母细胞瘤是源自周围交感神经系统的胚胎性肿瘤，也是儿童期最常见的颅外实体瘤，占所有儿童癌症死亡人
数的 15％。其预后多变，从自发消退到对治疗无反应的广泛转移等，部分难治性神经母细胞瘤尽管采用了多种模式综合疗
法，但预后仍不佳。为了进行准确的评估，根据年龄、分期和生物学肿瘤因素将患者进行危险分组，并需要进行多次临床和影
像学检查。核素成像兼具形态学及功能成像，是分期和评估的常用手段。神经母细胞瘤随着疾病进展，常伴肾上腺髓质功能
的亢进，生长抑素受体高表达及糖代谢的显著增加，并伴有儿茶酚胺和代谢产物、血清嗜铬粒蛋白显著增高。以正电子发射断
层/计算机断层（PET/CT）为代表的功能显像在神经母细胞瘤的诊断中发挥重要作用，并受到临床广泛关注。放射性核素诊疗
一体化有望成为难治性神经母细胞瘤诊疗新策略，准确判断分期和预后，实现神经母细胞瘤的分子分型，从而推动该疾病的精
准医疗。文章对儿童难治性神经母细胞瘤的核素诊疗一体化研究进展进行综述。
［关键词］ 神经母细胞瘤；核医学；儿童；发展趋势
［中图分类号］ R445.5 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）02⁃296⁃06
doi：10.7655/NYDXBNS20220225

Theragnostic advances of radionuclide in refractory neuroblastoma of children

1
ZHANG Xiaojun ，WANG Feng 2*
1 2
Imaging Center，Children’s Hospital of Nanjing Medical University，Nanjing 210008；Nuclear Medicine Center，
Nanjing First Hospital，Nanjing Medical University，Nanjing 210006，China

［Abstract］ Neuroblastoma is an embryonic tumor of the peripheral sympathetic nervous system. It is the most common extracranial
solid tumor of childhood and accounts for up to 15% of all pediatric cancer fatalities. It has a varied prognosis，ranging from
spontaneous regression to aggressive metastatic tumors with fatal outcomes despite multimodality therapy. Patients are divided into risk
groups on the basis of age，stage，and biologic tumor factors. Multiple clinical and imaging tests are needed for accurate patient
assessment. Nuclear medicine has both anatomical and functional imaging and is a useful method for staging and assessment. As the
disease progresses，neuroblastoma is often accompanied by increased adrenal medulla function，high expression of somatostatin
receptors and a significant increase in glucose metabolism，accompanied by catecholamines and metabolites，and a significant increase
in serum chromogranin. Positron emission tomography/computed tomography（PET/CT），as a functional imaging，plays an important
role in the diagnosis of neuroblastoma and has received widespread clinical attention. Theragnostic of nuclear medicine have emerged
and are demonstrating promising response rates for patients at high risk. This article reviews the research progress of radionuclide
theragnostic in children with refractory neuroblastoma.
［Key words］ neuroblastoma；nuclear medicine；children；trends
［J Nanjing Med Univ，2022，42（02）：296⁃301］

［基金项目］ 江苏政府留学奖学金（JS⁃2018⁃137）；江苏省妇幼保健课题（FYX201816）；南京市医学科技发展资金（QRX17169）
∗
通信作者（Corresponding author），E⁃mail：fengwangcn@hotmail.com