Ekmekcioglu Ozgul, Aliyev Anar, Yilmaz Sabire, Arslan Esra, Kaya Rana, Kocael Pinar, Erkan Melih Engin, Halac Metin, Sonmezoglu Kerim
Departments of aNuclear Medicine bGeneral Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul cDepartment of Nuclear Medicine, Duzce University Medical Faculty, Duzce, Turkey.
Nucl Med Commun. 2013 Nov;34(11):1055-67. doi: 10.1097/MNM.0b013e3283658369.
This study investigated the prognostic value of [18F]-fluorodeoxyglucose (18F-FDG) uptake in breast carcinomas by comparing 18F-FDG PET/computed tomography (CT) images with histopathological and immunohistochemical prognostic factors.
This study included 136 women and four men with positive biopsy breast carcinomas who underwent 18F-FDG PET/CT imaging for initial staging. Maximum standardized uptake values (SUVmax) and tumour-to-background SUVmax ratios were calculated and compared with histopathological and immunohistochemical tumour characteristics, patient properties and axillary lymph node involvement. Calculations of SUVmax for men were performed separately.
For the tumours in women, the mean SUVmax was 10.06±6.91 and the median SUVmax was 9.05 (0.7-35.0). Primary tumour 18F-FDG uptake and tumour-to-background SUVmax ratios were correlated with tumour size (P<0.001), histological type (P<0.001), histological grade (P=0.004), pleomorphism (P=0.010), mitosis count (P<0.001), lymphatic invasion (P=0.009), necrosis (P=0.005), oestrogen negativity (P=0.004), high Ki-67 level (P<0.001), axillary lymph node involvement (P<0.001) and triple negativity (P=0.002). High Ki-67 level (odds ratio=16; 95% confidence interval=1.6-160; P=0.016) and tumour size (odds ratio=4; 95% confidence interval=1.5-11; P=0.007) were determining factors for high 18F-FDG uptake values. Other clinicopathological and immunohistopathological parameters including progesterone receptor (P=0.211), CerbB2 overexpression (P=0.170), perineural invasion (P=0.053), intratumoural calcification (P=0.438), desmoplasia (P=0.112), tubular formation (P=0.768) and age (P=0.675) were not significantly correlated with 18F-FDG uptake. No significant relationship was observed between the tumour/contralateral breast SUVmax ratio and mitotic count, oestrogen receptor status or triple negativity.
F-FDG uptake may serve as a prognostic indicator for biological behaviour in breast tumours.
本研究通过将[18F] - 氟脱氧葡萄糖（18F - FDG）PET/计算机断层扫描（CT）图像与组织病理学和免疫组织化学预后因素进行比较，研究18F - FDG摄取在乳腺癌中的预后价值。
本研究纳入了136名女性和4名活检证实为阳性的乳腺癌男性患者，他们接受了18F - FDG PET/CT成像以进行初始分期。计算最大标准化摄取值（SUVmax）和肿瘤与背景SUVmax比值，并与组织病理学和免疫组织化学肿瘤特征、患者属性及腋窝淋巴结受累情况进行比较。男性的SUVmax计算单独进行。
对于女性患者的肿瘤，平均SUVmax为10.06±6.91，SUVmax中位数为9.05（0.7 - 35.0）。原发肿瘤18F - FDG摄取及肿瘤与背景SUVmax比值与肿瘤大小（P<0.001）、组织学类型（P<0.001）、组织学分级（P = 0.004）、多形性（P = 0.010）、有丝分裂计数（P<0.001）、淋巴管浸润（P = 0.009）、坏死（P = 0.005）、雌激素阴性（P = 0.004）、高Ki - 67水平（P<0.001）、腋窝淋巴结受累（P<0.001）及三阴性（P = 0.002）相关。高Ki - 67水平（比值比 = 16；95%置信区间 = 1.6 - 160；P = 0.016）和肿瘤大小（比值比 = 4；95%置信区间 = 1.5 - 11；P = 0.007）是高18F - FDG摄取值的决定因素。其他临床病理和免疫病理参数，包括孕激素受体（P = 0.211）、CerbB2过表达（P = 0.17）、神经周围浸润（P = 0.053）、肿瘤内钙化（P = 0.438）、促纤维组织增生（P = 0.112）、管状形成（P = 0.768）及年龄（P = ）与18F - FDG摄取无显著相关性。未观察到肿瘤/对侧乳腺SUVmax比值与有丝分裂计数、雌激素受体状态或三阴性之间存在显著关系。
18F - FDG摄取可能作为乳腺癌生物学行为的预后指标。
