~(18)F-FDG PET/CT SUV_(max)与乳腺浸润性导管癌临床病理特征及新辅助化疗疗效的相关性
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摘要
目的探讨18F-脱氧葡萄糖(FDG)正电子发射计算机断层扫描(PET/CT)显像治疗前病灶最大标准摄取值(maximum standard uptake value, SUV_(max))与乳腺浸润性导管癌临床病理特征的关系及与新辅助化疗疗效的相关性,以指导临床个体化治疗。方法选取佛山市第一人民医院行~(18)F-FDG PET/CT显像的272例初治乳腺浸润性导管癌患者的临床资料进行回顾性分析,测定原发病灶的SUV_(max),分析临床病理特征、分子分型及新辅助化疗疗效与原发灶SUV_(max)的相关性。结果乳腺癌原发灶的SUV_(max)在不同T分期、不同组织学分级、有无淋巴结转移方面差异均有统计学意义(P<0.05),雌激素受体(ER)和(或)孕激素受体(PR)阳性组与阴性组的SUV_(max)差异有统计学意义(P<0.05),人表皮生长因子受体2(HER2)阳性组与阴性组的SUV_(max)差异无统计学意义(P>0.05),Ki-67高表达者SUV_(max)高于低表达者(P<0.05)。Basal-like型和HER2过表达型SUV_(max)均高于Luminal A型乳腺癌(P<0.05)。病理完全缓解组与未达到病理缓解组SUV_(max)差异有统计学意义(P<0.05)。结论 ~(18)F-FDG PET/CT SUV_(max)与乳腺癌的临床病理特征具有较大的相关性,原发病灶SUV_(max)较高者更能从新辅助化疗中获益。
Objective To investigate the relationship between 18F-fluorodeoxy glucose(~(18)F-FDG) positron emission tomography/computed tomography(PET/CT) maximum standard uptake value(SUV_(max)) and clinicopathological features, neoadjuvant chemotherapy response in patients with invasive ductal breast carcinoma. Methods We retrospectively reviewed the medical records of 272 breast cancer patients who underwent ~(18)F-FDG PET/CT in our hospital. SUV_(max) of primary lesions were measured. The relationship of primary lesion SUV_(max) with the clinicopathological features, molecular subtype and neoadjuvant chemotherapy response was analyzed. Results There were statistically significant differences of primary lesion SUV_(max) in different T stages, pathological stage, with or without lymph node invasion(all P<0.05). SUV_(max) of estrogen receptor(ER) and progesterone receptor(PR) negative patients were higher than that of ER and(or)PR positive patients(P<0.05). No significant difference of SUV_(max) was found between human epidermal growth factor receptor 2(HER-2)negative and positive patients(P>0.05). SUV_(max) of primary lesion were higher in patients with Ki-67≥14% than that with Ki-67<14%(P<0.05). SUV_(max) in Basal-like and HER2 overexpression groups were higher than that in Luminal A group(P<0.05). SUV_(max) in pathologic complete response(pCR) group was higher than that in no pCR group(P<0.05). Conclusion ~(18)F-FDG PET/CT SUV_(max) is correlated with clinicopathological feature of breast cancer patients. Patients with higher SUV_(max) of primary lesion could benefit better from neoadjuvant chemotherapy.
Objective To investigate the relationship between 18F-fluorodeoxy glucose(~(18)F-FDG) positron emission tomography/computed tomography(PET/CT) maximum standard uptake value(SUV_(max)) and clinicopathological features, neoadjuvant chemotherapy response in patients with invasive ductal breast carcinoma. Methods We retrospectively reviewed the medical records of 272 breast cancer patients who underwent ~(18)F-FDG PET/CT in our hospital. SUV_(max) of primary lesions were measured. The relationship of primary lesion SUV_(max) with the clinicopathological features, molecular subtype and neoadjuvant chemotherapy response was analyzed. Results There were statistically significant differences of primary lesion SUV_(max) in different T stages, pathological stage, with or without lymph node invasion(all P<0.05). SUV_(max) of estrogen receptor(ER) and progesterone receptor(PR) negative patients were higher than that of ER and(or)PR positive patients(P<0.05). No significant difference of SUV_(max) was found between human epidermal growth factor receptor 2(HER-2)negative and positive patients(P>0.05). SUV_(max) of primary lesion were higher in patients with Ki-67≥14% than that with Ki-67<14%(P<0.05). SUV_(max) in Basal-like and HER2 overexpression groups were higher than that in Luminal A group(P<0.05). SUV_(max) in pathologic complete response(pCR) group was higher than that in no pCR group(P<0.05). Conclusion ~(18)F-FDG PET/CT SUV_(max) is correlated with clinicopathological feature of breast cancer patients. Patients with higher SUV_(max) of primary lesion could benefit better from neoadjuvant chemotherapy.
引文
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[12]张月明,周晔明,徐海燕,等.18F-FDG PET/CT在复发转移性乳腺癌中的临床价值[J].肿瘤,2018,38(7):704-10.[Zhang YM,Zhou YM,Xu HY,et al.Clinical value of 18F-FDG-PET/CT in recurrent and metastatic breast cancer[J].Zhong Liu,2018,38(7):704-10.]
[13]张倩,辛军,李红.18F-FDG PET/CT显像半定量参数MTV、TLG联合SUV在乳腺癌诊断中的应用价值[J].中国临床医学影像杂志,2016,27(9):620-4.[Zhang Q,Xin J,Li H.Clinical value of 18F-FDG uptake,described by metabolic tumor volume,total lesion glycolysis and standard uptake values in breast cancer[J].Zhongguo Lin Chuang Yi Xue Ying Xiang Za Zhi,2016,27(9):620-4.]
[14]周国江,杨勇,赵子龙,等.乳腺癌HER-2基因扩增与HER-2neu蛋白表达的一致性及其与临床病理特征的关系[J].实用癌症杂志,2018,33(5):728-31.[Zhou GJ,Yang Y,Zhao ZL,et al.Study on the relationship between the expression of HER-2 gene and the expression of HER2neu protein in breast cancer and its relationship with clinicopathological features[J].Shi Yong Ai Zheng Za Zhi,2018,33(5):728-31.]
[15]Elkablawy MA,Albasri AM,Mohammed RA,et al.Ki67expression in breast cancer.Correlation with prognostic markers and clinicopathological parameters in Saudi patients[J].Saudi Med J,2016,37(2):137-41.
[16]杨欢,林美福,陈晓耕.乳腺癌18F-脱氧葡萄糖PET-CT标准化摄取值与Ki-67表达的关系及意义[J].南昌大学学报(医学版),2012,52(3):52-5,57.[Yang H,Lin MF,Chen XG.Relationship between standardized uptake value of 18F-FDG PET/CT and Ki67 expression in breast cancer[J].Nan Chang Da Xue Xue Bao(Yi Xue Ban),2012,52(3):52-5,57.]
[17]冯彦林,鲁胜男,杨劼,等.18F-FDG PET/CT预测乳腺癌新辅助化疗病理反应的价值[J].肿瘤防治研究,2012,39(10):1224-7.[Feng YL,Lu SN,Yang J,et al.Valuation of 18F-FDG PET/CTin predicting pathological reaction of neoadjuvant chemotherapy with breast cancer[J].Zhong Liu Fang Zhi Yan Jiu,2012,39(10):1224-7.]
[18]张立清,张喜平.18F-FDG PET-CT与乳腺癌新辅助化疗疗效中的关联性分析[J].医学研究杂志,2017,46(1):77-9.[Zhang LQ,Zhang XP.Association between 18F-FDG PET-CT and curative effect of neoadjuvant chemotherapy for breast cancer[J].Yi Xue Yan Jiu Za Zhi,2017,46(1):77-9.]
[2]李雯,冯彦林.乳腺癌分子生物学指标与18F-FDG PET-CTSUVmax的相关性研究[J].中国现代医学杂志,2017,27(23):47-51.[Li W,Feng YL.Correlations of 18F-FDG PET-CT SUVmax with molecular biological markers of breast cancer[J].Zhongguo Xian Dai Yi Xue Za Zhi,2017,27(23):47-51.]
[3]Piva R,Ticconi F,Ceriani V,et al.Comparative diagnostic accuracy of 18F-FDG PET/CT for breast cancer recurrence[J].Breast Cancer(Dove Med Press),2017,9:461-71.
[4]Tural D,Kivark Salim D,Mutlu H,et al.Is there any relation between PET-CT SUVmax value and prognostic factors in locally advanced breast cancer?[J].J BUON,2015,20(5):1282-6.
[5]Kumar R,Halanaik D,Malhotra A.Clinical applications of positron emission tomography-computed tomography in oncology[J].Indian J Cancer,2010,47(2):100-19.
[6]Ege Aktas G,Ta?tekin E,Sarikaya A.Assessment of biological and clinical aggressiveness of invasive ductal breast cancer using baseline 18F-FDG PET/CT-derived volumetric parameters[J].Nucl Med Commun,2018,39(1):83-93.
[7]徐巧玲,尤徐阳,郁春景,等.影响乳腺浸润性导管癌原发病灶摄取18F-FDG的相关因素分析[J].中华核医学与分子影像杂志,2016,36(5):413-9.[Xu QL,You XY,Yu CJ,et al.Analysis of relevant factors influencing 18F-FDG uptake in primary lesion of breast invasive ductal carcinoma[J].Zhonghua He Yi Xue Yu Fen Zi Ying Xiang Za Zhi,2016,36(5):413-9.
[8]汤泊,张银,周锦,等.18F-FDG PET-CT代谢参数与乳腺癌临床病理特征的关系[J].中华肿瘤杂志,2017,39(4):280-5.[Tang B,Zhang Y,Zhou J,et al.The relationship between 18F-FDG PET-CTmetabolic parameters and clinicopathological features of breast cancer[J].Zhonghua Zhong Liu Za Zhi,2017,39(4):280-5.]
[9]Koo HR,Park JS,Kang KW,et al.18F-FDG uptake in breast cancer correlates with immunohistochemically defined subtypes[J].Eur Radiol,2014,24(3):610-8.
[10]Cokmert S,Tanriverdi O,Karapolat I,et al.The maximum standardized uptake value of metastasis site in 18F-FDG PET/CTpredicts molecular subtypes and survival in metastasis breast cancer:An Izmir Oncology Group study[J].J BUON,2016,21(6):1410-8.
[11]Palmieri D,Bronder JL,Herring JM,et al.Her-2 overexpression increases the metastatic outgrowth of breast cancer cells in the brain[J].Cancer Res,2007,67(9):4190-8.
[12]张月明,周晔明,徐海燕,等.18F-FDG PET/CT在复发转移性乳腺癌中的临床价值[J].肿瘤,2018,38(7):704-10.[Zhang YM,Zhou YM,Xu HY,et al.Clinical value of 18F-FDG-PET/CT in recurrent and metastatic breast cancer[J].Zhong Liu,2018,38(7):704-10.]
[13]张倩,辛军,李红.18F-FDG PET/CT显像半定量参数MTV、TLG联合SUV在乳腺癌诊断中的应用价值[J].中国临床医学影像杂志,2016,27(9):620-4.[Zhang Q,Xin J,Li H.Clinical value of 18F-FDG uptake,described by metabolic tumor volume,total lesion glycolysis and standard uptake values in breast cancer[J].Zhongguo Lin Chuang Yi Xue Ying Xiang Za Zhi,2016,27(9):620-4.]
[14]周国江,杨勇,赵子龙,等.乳腺癌HER-2基因扩增与HER-2neu蛋白表达的一致性及其与临床病理特征的关系[J].实用癌症杂志,2018,33(5):728-31.[Zhou GJ,Yang Y,Zhao ZL,et al.Study on the relationship between the expression of HER-2 gene and the expression of HER2neu protein in breast cancer and its relationship with clinicopathological features[J].Shi Yong Ai Zheng Za Zhi,2018,33(5):728-31.]
[15]Elkablawy MA,Albasri AM,Mohammed RA,et al.Ki67expression in breast cancer.Correlation with prognostic markers and clinicopathological parameters in Saudi patients[J].Saudi Med J,2016,37(2):137-41.
[16]杨欢,林美福,陈晓耕.乳腺癌18F-脱氧葡萄糖PET-CT标准化摄取值与Ki-67表达的关系及意义[J].南昌大学学报(医学版),2012,52(3):52-5,57.[Yang H,Lin MF,Chen XG.Relationship between standardized uptake value of 18F-FDG PET/CT and Ki67 expression in breast cancer[J].Nan Chang Da Xue Xue Bao(Yi Xue Ban),2012,52(3):52-5,57.]
[17]冯彦林,鲁胜男,杨劼,等.18F-FDG PET/CT预测乳腺癌新辅助化疗病理反应的价值[J].肿瘤防治研究,2012,39(10):1224-7.[Feng YL,Lu SN,Yang J,et al.Valuation of 18F-FDG PET/CTin predicting pathological reaction of neoadjuvant chemotherapy with breast cancer[J].Zhong Liu Fang Zhi Yan Jiu,2012,39(10):1224-7.]
[18]张立清,张喜平.18F-FDG PET-CT与乳腺癌新辅助化疗疗效中的关联性分析[J].医学研究杂志,2017,46(1):77-9.[Zhang LQ,Zhang XP.Association between 18F-FDG PET-CT and curative effect of neoadjuvant chemotherapy for breast cancer[J].Yi Xue Yan Jiu Za Zhi,2017,46(1):77-9.]