采用漫射光学光谱断层成像术评估肿瘤血管生成变化：在接受新辅助化疗的浸润性乳腺癌女性中是否存在相关性？
Tumor angiogenesis change estimated by using diffuse optical spectroscopic tomography: demonstrated correlation in women undergoing neoadjuvant chemotherapy for invasive breast cancer?
机构信息
Department of Pathology, Dartmouth Medical School, Hanover, NH 03755, USA.
出版信息
Radiology. 2011 May;259(2):365-74. doi: 10.1148/radiol.11100699. Epub 2011 Mar 15.
PURPOSE
To investigate if changes in tumor angiogenesis associated with complete pathologic response (pCR) or partial pathologic response (pPR) to treatment can be demonstrated by using diffuse optical spectroscopic (DOS) tomography.
MATERIALS AND METHODS
All participants in this prospective, HIPAA-compliant, institutional review board-approved study provided written informed consent. Eleven women with invasive breast carcinoma were imaged with DOS tomography prior to, during, and at completion of neoadjuvant chemotherapeutic regimens. By using region of interest (ROI) analysis, the DOS measure of total tissue hemoglobin (Hb(T)) was temporally correlated with quantitative measures of existing (CD31-expressing) and tumor-induced (CD105-expressing) vessels, in pretreatment and posttreatment tissue specimens, to assess change.
RESULTS
Quantified angiogenesis alone in pretreatment core biopsy specimens did not predict treatment response, but mean vessel density (MVD) and mean vessel area (MVA) of CD105-expressing vessels were significantly decreased in women with pCR (n = 7) (P < .001 and P = .003, respectively). MVA of CD105-expressing vessels was also significantly reduced at comparison of pre- and posttreatment residual tumor for women with pPR (n = 4) (P = .033). A longitudinal analysis showed significant decreases (P = .001) in mean Hb(T) levels during neoadjuvant chemotherapy in breast abnormality ROIs for women with pCR but not women with pPR. For women with pCR, but not women with pPR, pretreatment MVD of CD105-expressing vessels correlated with pretreatment Hb(T) (P ≤ .001).
CONCLUSION
DOS tomographic examinations in women with breast cancer who are receiving neoadjuvant chemotherapy show a mean decrease in Hb(T) with time in patients with pCR only. Observed pretreatment and posttreatment correlates with quantified angiogenesis markers confirm the likely biologic origin for this DOS signature and support its potential to predict angiogenic tissue response early in the treatment cycle.
SUPPLEMENTAL MATERIAL
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11100699/-/DC1.
目的
利用漫射光学断层成像术（DOS 断层成像术）研究与治疗后完全病理缓解（pCR）或部分病理缓解（pPR）相关的肿瘤血管生成变化是否可以被检测到。
材料与方法
本前瞻性研究符合 HIPAA 规定，经机构审查委员会批准，所有参与者均签署了知情同意书。11 名患有浸润性乳腺癌的女性在新辅助化疗方案开始前、进行中和完成时，接受 DOS 断层成像术检查。通过感兴趣区域（ROI）分析，将 DOS 测量的总组织血红蛋白（Hb(T)）与预处理和治疗后组织标本中现有的（CD31 表达）和肿瘤诱导的（CD105 表达）血管的定量测量进行时间相关性分析，以评估变化。
结果
仅对预处理核心活检标本进行的定量血管生成分析不能预测治疗反应，但 pCR（n = 7）女性的 CD105 表达血管的平均血管密度（MVD）和平均血管面积（MVA）显著降低（P <.001 和 P =.003）。pPR（n = 4）女性治疗后残留肿瘤的 CD105 表达血管 MVA 也显著降低（P =.033）。纵向分析显示，pCR 女性的新辅助化疗期间乳腺异常 ROI 中 Hb(T)水平显著降低（P =.001），但 pPR 女性则不然。对于 pCR 女性，而非 pPR 女性，预处理 CD105 表达血管的 MVD 与预处理 Hb(T)相关（P ≤.001）。
结论
接受新辅助化疗的乳腺癌女性的 DOS 断层成像检查显示，仅 pCR 女性随时间推移 Hb(T)呈均值下降。观察到的预处理和治疗后相关性与定量血管生成标志物一致，证实了该 DOS 特征的潜在生物学起源，并支持其在治疗早期预测血管组织反应的潜力。
补充材料
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11100699/-/DC1.
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