Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
Oncologist. 2011;16(6):772-82. doi: 10.1634/theoncologist.2010-0378. Epub 2011 May 31.
Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) may reveal distant metastases more accurately than conventional imaging (CT, skeletal scintigraphy, chest radiography). We hypothesized that patients diagnosed with stage III noninflammatory breast cancer (non-IBC) and IBC by conventional imaging with PET/CT have a better prognosis than patients diagnosed without PET/CT.
We retrospectively identified 935 patients with stage III breast cancer in 2000-2009. We compared the relapse-free survival (RFS) and overall survival (OS) times of patients diagnosed by conventional imaging with those of patients diagnosed by conventional imaging plus PET/CT. Univariate and multivariate Cox proportional hazards regression models were used to assess associations between survival and PET/CT.
RFS and OS times were not significantly different between patients imaged with PET/CT and those imaged without PET/CT. However, the RFS time in IBC patients was significantly different between patients imaged with PET/CT and those imaged without PET/CT on both univariate (hazard ratio [HR], 0.43; p = .014) and multivariate (HR, 0.33; p = .004) analysis. There was a trend for a longer OS duration in IBC patients imaged with PET/CT.
Among IBC patients, adding PET/CT to staging based on conventional imaging might detect patients with metastases that were not detected by conventional imaging. The use of conventional imaging with PET/CT for staging in non-IBC patients is not justified on the basis of these retrospective data. The use of conventional imaging plus PET/CT in staging IBC needs to be studied prospectively to determine whether it will improve prognosis.
氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）比常规成像（CT、骨闪烁扫描、胸部 X 线摄影）更能准确地发现远处转移。我们假设通过常规成像加 PET/CT 诊断为 III 期非炎性乳腺癌（非 IBC）和 IBC 的患者比未进行 PET/CT 检查的患者预后更好。
我们回顾性地确定了 2000 年至 2009 年期间的 935 例 III 期乳腺癌患者。我们比较了通过常规成像诊断的患者与通过常规成像加 PET/CT 诊断的患者的无复发生存（RFS）和总生存（OS）时间。使用单变量和多变量 Cox 比例风险回归模型来评估生存与 PET/CT 之间的关联。
接受和未接受 PET/CT 成像的患者的 RFS 和 OS 时间没有显著差异。然而，在单变量（风险比 [HR]，0.43；p =.014）和多变量（HR，0.33；p =.004）分析中，IBC 患者的 RFS 时间在接受和未接受 PET/CT 成像的患者之间有显著差异。接受 PET/CT 成像的 IBC 患者的 OS 时间有延长的趋势。
在 IBC 患者中，在常规成像基础上增加 PET/CT 分期可能会检测到常规成像未检测到的转移灶。基于这些回顾性数据，非 IBC 患者常规成像加 PET/CT 分期并不合理。需要前瞻性研究常规成像加 PET/CT 在 IBC 分期中的应用，以确定其是否能改善预后。
