生长抑素受体在非神经内分泌肿瘤中的表达及诊疗一体化应用：从分子到临床的综述

文献信息

中文摘要

生长抑素受体（SSTR）靶向成像和治疗是神经内分泌肿瘤的成熟方法，但越来越多的证据表明，SSTR也在多种非神经内分泌肿瘤中表达。本综述旨在总结其表达模式、成像特征及诊疗一体化潜力。本文回顾了已发表的中枢神经系统肿瘤、头颈癌、甲状腺癌、肺癌、乳腺癌、淋巴瘤和黑色素瘤相关证据，特别关注SSTR表达的细胞定位及放射性示踪剂摄取的机制。脑膜瘤、非角化型鼻咽癌及部分雌激素受体阳性乳腺癌显示相对显著的肿瘤细胞SSTR表达。在其他几种恶性肿瘤中，SSTR表达可能主要涉及肿瘤相关巨噬细胞、内皮细胞、成纤维细胞或其他基质成分。影像学发现在不同肿瘤类型之间及同一类型内部均存在异质性。初步研究提示，肽受体放射性核素治疗可能使部分SSTR阳性非神经内分泌肿瘤患者获得临床获益，但现有证据仍然有限，且大多不是前瞻性研究。需要进一步开展整合定量分子影像、空间病理学和分子谱分析的研究，以阐明受体生物学、建立患者选择标准，并明确SSTR靶向诊疗一体化在神经内分泌肿瘤之外的临床作用。

英文摘要

Somatostatin receptor (SSTR)-targeted imaging and therapy are established approaches for neuroendocrine tumors, but accumulating evidence indicates that SSTRs are also expressed in various non-neuroendocrine tumors. This review aimed to summarize their expression patterns, imaging characteristics, and theranostic potential. Published evidence was reviewed for central nervous system tumors, head and neck cancers, thyroid carcinoma, lung cancer, breast cancer, lymphoma, and melanoma, with particular attention to the cellular localization of SSTR expression and the mechanisms underlying radiotracer uptake. Meningioma, non-keratinizing nasopharyngeal carcinoma, and selected estrogen receptor-positive breast cancers show relatively prominent tumor-cell SSTR expression. In several other malignancies, SSTR expression may predominantly involve tumor-associated macrophages, endothelial cells, fibroblasts, or other stromal components. Imaging findings are heterogeneous across and within tumor types. Preliminary studies suggest that peptide receptor radionuclide therapy may provide clinical benefit in selected patients with SSTR-positive non-neuroendocrine tumors, although the available evidence remains limited and largely non-prospective. Further studies integrating quantitative molecular imaging, spatial pathology, and molecular profiling are needed to clarify receptor biology, establish patient-selection criteria, and define the clinical role of SSTR-targeted theranostics beyond neuroendocrine tumors.