Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan.
Eur J Nucl Med Mol Imaging. 2011 Jan;38(1):37-45. doi: 10.1007/s00259-010-1589-8. Epub 2010 Aug 18.
To investigate the correlation between uptake of 16α-[(18)F]fluoro-17β-oestradiol (FES) and expression of oestrogen receptors as well as other related immunohistochemistry markers, positron emission tomography (PET) was performed in patients with endometrial carcinoma before surgery.
Nineteen patients with endometrioid adenocarcinoma underwent preoperative PET studies with FES and 2-[(18)F]fluoro-2-deoxy-D: -glucose (FDG). Standardized uptake values (SUVs) for each tracer and the regional FDG to FES SUV ratio were calculated using images after coregistration. PET values were compared with postoperative stage, differentiation grade and immunohistochemical scores including oestrogen receptor subtypes (ERα, ERβ), progesterone receptor B (PR-B), Ki-67 and glucose transporter 1 (GLUT1).
FES uptake showed a significantly positive correlation with expression of ERα. The FDG to FES ratio showed a significantly negative correlation with expression of ERα and PR-B. The FES uptake and FDG to FES ratio did not correlate with expression of ERβ, Ki-67 or GLUT1. FDG uptake was not correlated with any of the immunohistochemical scores. The PR-B score was strongly correlated with the ERα score. Well-differentiated carcinoma (grade 1) showed a significantly higher FES uptake and significantly lower FDG to FES ratio than moderately or poorly differentiated carcinoma (grade 2-3). None of the PET parameters were significantly different between advanced-stage carcinoma (≥ stage IB) and early-stage carcinoma (IA) based on the Féderation International de Gynécologie et d'Obstétrique (FIGO) staging classification. Differentiation grade was the most closely correlated parameter to FES uptake and FDG to FES ratio by multivariate analyses.
FES PET combined with FDG would be useful for non-invasive evaluation of ERα distribution, as well as ERα function, which reflects differentiation grade in endometrial carcinoma.
在子宫内膜癌患者术前，通过正电子发射断层扫描（PET）研究 16α-[(18)F]氟-17β-雌二醇（FES）摄取与雌激素受体表达及其他相关免疫组织化学标志物之间的相关性。
19 例子宫内膜样腺癌患者在术前进行 FES 和 2-[(18)F]氟-2-脱氧-D：-葡萄糖（FDG）的 PET 研究。通过图像配准后计算每个示踪剂的标准化摄取值（SUV）和 FDG 与 FES SUV 比值的区域性比值。PET 值与术后分期、分化程度以及包括雌激素受体亚型（ERα、ERβ）、孕激素受体 B（PR-B）、Ki-67 和葡萄糖转运蛋白 1（GLUT1）在内的免疫组化评分进行比较。
FES 摄取与 ERα 表达呈显著正相关。FDG 与 FES 的比值与 ERα 和 PR-B 的表达呈显著负相关。FES 摄取和 FDG 与 FES 的比值与 ERβ、Ki-67 或 GLUT1 的表达均无相关性。FDG 摄取与任何免疫组化评分均无相关性。PR-B 评分与 ERα 评分呈强相关性。高分化癌（1 级）的 FES 摄取明显高于中低分化癌（2-3 级），而 FDG 与 FES 的比值明显较低。基于国际妇产科联合会（FIGO）分期分类，晚期（≥IB 期）与早期（IA 期）的癌之间，无任何 PET 参数存在显著差异。通过多变量分析，分化程度是与 FES 摄取和 FDG 与 FES 比值相关性最密切的参数。
FES PET 联合 FDG 有助于非侵入性评估 ERα 的分布及其功能，这反映了子宫内膜癌的分化程度。
