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evket Ruacan
skender Sayek
men Baltalïkun F. BekdikDepartments of Nuclear Medicine, Pathology, Surgery, Medical Oncology and Cancer Epidemiology, Hacettepe University Medical Faculty, Ankara, Turkey
Correspondence: For correspondence or reprints contact: Lale Kostakoglu, MD, Hacettepe Universitesi Tïp Fakültesi,Nükleer Tïp Anabilim Dalï, Sïhhiye 06100 Ankara, Turkey
ABSTRACT
We prospectively studied 48 patients with either breast cancer (30 patients) or lung cancer (18 patients) to ascertain the relationship between the degree of accumulation of 99mTc-sestamibi and the expression of p-glycoprotein in tumor tissues. Methods: During initial presentation (37 patients) or post-therapy evaluation (11 patients), the patients underwent contemporaneous 99mTc-sestamibi imaging and biopsy (30 patients) or surgery (18 patients). The interval between surgery/biopsy and imaging varied between 3 and 15 days. All patients had radiologically detectable tumors. Immuno-histochemical studies were performed on paraffin sections using a monoclonal antibody, JSB-1, developed against the internal epitope of p-glycoprotein. Tumor-to-background ratios were correlated with the level of p-glycoprotein expression determined by immunohisto-chemical studies. Results: Our results showed an inverse correlation between the tumor-to-background ratios of 99mTc-sestamibi and the density of p-glycoprotein expression in tumor tissues. The values for the tumor-to-background ratios were significantly lower for those tumors expressing p-glycoprotein at high levels than those with scattered and no expression (p < 0.01 and p < 0.001, respectively). Conclusion: Although our results warrant further studies at the molecular level using PCR techniques after the extraction of mRNA, our data strongly suggest that 99mTc-sestamibi imaging is useful to noninvasively determine the presence of multidrug resistance in patients with malignant tumors.
Key Words: multidrug resistance • P-glycoprotein • technetium-99m-sestamibi
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