Division of Nuclear Medicine, European Institute of Oncology, Milan, Italy.
Breast. 2013 Feb;22(1):39-43. doi: 10.1016/j.breast.2012.05.009. Epub 2012 Jun 14.
We retrospectively investigated (18)F-FDG uptake by the primary breast tumor as a predictor for relapse and survival.
We studied 203 patients with cT1-T3N0 breast cancer. Standardized uptake value (SUVmax), was measured on the primary tumor. After a median follow-up of 68 months (range 22-80), the relation between SUVmax and tumor factors, disease free-survival (DFS) and overall survival (OS) was investigated.
In the PET-positive patients, the median FDG uptake by the tumor was 4.7. FDG uptake was significantly related to tumor size, number of involved axillary nodes, grade, negative ER, high Ki-67 and HER2 overexpression. No distant metastases or deaths occurred in the PET-negative group. Five-year DFS was 97% and 83%, respectively in the PET-negative and PET-positive groups (P = 0.096). At univariate analysis, DFS was significantly lower in patients with SUVmax >4.7 compared to the patients with negative PET (P = 0.042), but not to the patients with SUVmax ≤4.7 (P = 0.106). At multivariable analysis, among PET-positive patients, SUVmax was not an independent prognostic factor for DFS (HR(>4.7 vs ≤4.7): 1.02 (95% CI 0.45-2.31)). Five-year OS was 100% and 93%, respectively, in the PET-negative and PET-positive groups (P = 0.126).
FDG uptake by the primary lesion was significantly associated with several prognostic variables, but it was not an independent prognostic factor.
我们回顾性研究了（18）F-FDG 摄取的原发性乳腺癌作为复发和生存的预测因素。
我们研究了 203 例 cT1-T3N0 乳腺癌患者。原发性肿瘤测量标准化摄取值（SUVmax）。中位随访 68 个月（范围 22-80）后，SUVmax 与肿瘤因素、无病生存（DFS）和总生存（OS）的关系进行了研究。
在 PET 阳性患者中，肿瘤的中位 FDG 摄取量为 4.7。FDG 摄取与肿瘤大小、腋窝淋巴结受累数量、分级、ER 阴性、Ki-67 高表达和 HER2 过表达显著相关。在 PET 阴性组中，无远处转移或死亡。5 年 DFS 分别为 PET 阴性组和 PET 阳性组的 97%和 83%（P = 0.096）。单因素分析显示，SUVmax>4.7 的患者 DFS 明显低于 PET 阴性患者（P = 0.042），但与 SUVmax≤4.7 的患者相比（P = 0.106），无统计学差异。多因素分析显示，在 PET 阳性患者中，SUVmax 不是 DFS 的独立预后因素（SUVmax>4.7 与 SUVmax≤4.7 相比：1.02（95%CI 0.45-2.31））。5 年 OS 分别为 PET 阴性组和 PET 阳性组的 100%和 93%（P = 0.126）。
原发性病变的 FDG 摄取与多个预后变量显著相关，但不是独立的预后因素。
