Papantoniou Vassilios J, Souvatzoglou Michael A, Valotassiou Varvara J, Louvrou Androniki N, Ambela Constantina, Koutsikos John, Lazaris Dimitrios, Christodoulidou Julie K, Sotiropoulou Maria G, Melissinou Maria J, Perperoglou Aris, Tsiouris Spyridon, Zerva Cherry J
Department of Nuclear Medicine, Alexandra University Hospital, Athens, Greece.
Breast Cancer Res. 2004;6(2):R56-62. doi: 10.1186/bcr751. Epub 2003 Dec 11.
The aim of the present study was to identify the relationships between the uptake of radiotracers - namely pentavalent dimercaptosuccinic acid [(V)DMSA] and sestamibi (MIBI) - and the following parameters in primary breast cancer: steroid receptor concentrations (i.e. estrogen receptor [ER] and progesterone receptor [PR]), Ki-67 expression, tumor size, tumor grade, age, and levels of expression of p53 and c-erbB-2. In addition, by multivariate regression analysis, we further isolated those factors with independent associations with (V)DMSA and/or MIBI uptake in primary breast cancer.
Thirty-four patients with histologically confirmed breast carcinoma underwent preoperative scintimammography with technetium-99m (99mTc)-(V)DMSA and/or 99mTc-MIBI in consecutive sessions 10 and 60 min after administration of 925-1110 MBq of each radiotracer. The tumor-to-background ratio was calculated and correlated with the presence of ER, PR, Ki-67, tumor size, tumor grade, p53, and c-erbB-2. ER, PR, p53, and c-erbB-2 were determined immunohistochemically. The analysis included tumor-to-background ratio of (V)DMSA and MIBI uptake as dependent and all of the other parameters as independent variables.
Correlation was positive between Ki-67 and (V)DMSA (r = 0.37 at 10 min, P = 0.038; r = 0.42 at 60 min, P = 0.018) and inverse between PR and (V)DMSA uptake (r = -0.46 at 10 min, P = 0.010; r = -0.51 at 60 min, P = 0.003). Multivariate regression analysis demonstrated a positive correlation between Ki-67 and (V)DMSA at 60 min (P = 0.045). Ki-67 was not significantly correlated with MIBI uptake, whereas tumor size was positively correlated with MIBI uptake at 60 min both in univariate (r = 0.45, P = 0.027) and multivariate analysis (P = 0.024). Negative correlations were observed between (V)DMSA uptake and ER, as well as between ER/PR and MIBI uptake, but these were not significant.
Ki-67 appears to represent the major independent factor affecting (V)DMSA uptake in breast cancer. Tumor size was the only independent parameter influencing MIBI uptake in breast cancer. (V)DMSA appears to have an advantage over MIBI in that it can be used to visualize tumors with intense proliferative activity, and thus it can identify those tumors that are more aggressive.
本研究旨在确定放射性示踪剂——即五价二巯基丁二酸[（V）DMSA]和甲氧基异丁基异腈（MIBI）——的摄取与原发性乳腺癌的以下参数之间的关系：类固醇受体浓度（即雌激素受体[ER]和孕激素受体[PR]）、Ki-67表达、肿瘤大小、肿瘤分级、年龄以及p53和c-erbB-2的表达水平。此外，通过多变量回归分析，我们进一步分离出与原发性乳腺癌中（V）DMSA和/或MIBI摄取具有独立关联的那些因素。
34例经组织学确诊的乳腺癌患者在分别给予925 - 1110MBq每种放射性示踪剂后的第10分钟和第60分钟连续进行术前乳腺闪烁显像，使用锝-99m（99mTc）-（V）DMSA和/或99mTc-MIBI。计算肿瘤与本底比值，并将其与ER、PR、Ki-67、肿瘤大小、肿瘤分级、p53和c-erbB-2的存在情况进行关联分析。ER、PR、p53和c-erbB-2通过免疫组织化学方法测定。分析将（V）DMSA和MIBI摄取的肿瘤与本底比值作为因变量，所有其他参数作为自变量。
Ki-67与（V）DMSA呈正相关（10分钟时r = 0.37，P = 0.038；60分钟时r = 0.42，P = 0.018），PR与（V）DMSA摄取呈负相关（10分钟时r = -0.46，P = 0.010；60分钟时r = -0.51，P = 0.003）。多变量回归分析显示60分钟时Ki-67与（V）DMSA呈正相关（P = 0.045）。Ki-67与MIBI摄取无显著相关性，而肿瘤大小在单变量分析（r = 0.45，P = 0.027）和多变量分析（P = 0.024）中均与60分钟时的MIBI摄取呈正相关。观察到（V）DMSA摄取与ER之间以及ER/PR与MIBI摄取之间存在负相关，但这些均无统计学意义。
Ki-67似乎是影响乳腺癌中（V）DMSA摄取的主要独立因素。肿瘤大小是影响乳腺癌中MIBI摄取的唯一独立参数。（V）DMSA似乎比MIBI具有优势，因为它可用于使具有强烈增殖活性的肿瘤显影，从而能够识别那些更具侵袭性 的肿瘤。
