基于雌激素受体、孕激素受体和人表皮生长因子受体2的乳腺癌亚型与⁶⁸Ga-RGD PET/CT及¹⁸F-FDG PET/CT功能成像参数的相关性

Correlation of breast cancer subtypes, based on estrogen receptor, progesterone receptor, and HER2, with functional imaging parameters from ⁶⁸Ga-RGD PET/CT and ¹⁸F-FDG PET/CT.

作者信息

Yoon Hai-Jeon, Kang Keon Wook, Chun In Kook, Cho Nariya, Im Seock-Ah, Jeong Sunjoo, Lee Song, Jung Kyeong Cheon, Lee Yun-Sang, Jeong Jae Min, Lee Dong Soo, Chung June-Key, Moon Woo Kyung

机构信息

Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.

出版信息

Eur J Nucl Med Mol Imaging. 2014 Aug;41(8):1534-43. doi: 10.1007/s00259-014-2744-4. Epub 2014 Mar 21.

DOI:10.1007/s00259-014-2744-4

PMID:24652232

Abstract

PURPOSE

Imaging biomarkers from functional imaging modalities were assessed as potential surrogate markers of disease status. Specifically, in this prospective study, we investigated the relationships between functional imaging parameters and histological prognostic factors and breast cancer subtypes.

METHODS

In total, 43 patients with large or locally advanced invasive ductal carcinoma (IDC) were analyzed (47.6 ± 7.5 years old). (68)Ga-Labeled arginine-glycine-aspartic acid (RGD) and (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were performed. The maximum and average standardized uptake values (SUVmax and SUVavg) from RGD PET/CT and SUVmax and SUVavg from FDG PET/CT were the imaging parameters used. For histological prognostic factors, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression was identified using immunohistochemistry (IHC) or fluorescent in situ hybridization (FISH). Four breast cancer subtypes, based on ER/PR and HER2 expression (ER/PR+,Her2-, ER/PR+,Her2+, ER/PR-,Her2+, and ER/PR-,Her2-), were considered.

RESULTS

Quantitative FDG PET parameters were significantly higher in the ER-negative group (15.88 ± 8.73 vs 10.48 ± 6.01, p = 0.02 for SUVmax; 9.40 ± 5.19 vs 5.92 ± 4.09, p = 0.02 for SUVavg) and the PR-negative group (8.37 ± 4.94 vs 4.79 ± 3.93, p = 0.03 for SUVavg). Quantitative RGD PET parameters were significantly higher in the HER2-positive group (2.42 ± 0.59 vs 2.90 ± 0.75, p = 0.04 for SUVmax; 1.60 ± 0.38 vs 1.95 ± 0.53, p = 0.04 for SUVavg) and showed a significant positive correlation with the HER2/CEP17 ratio (r = 0.38, p = 0.03 for SUVmax and r = 0.46, p < 0.01 for SUVavg). FDG PET parameters showed significantly higher values in the ER/PR-,Her2- subgroup versus the ER/PR+,Her2- or ER/PR+,Her2+ subgroups, while RGD PET parameters showed significantly lower values in the ER/PR-,Her2- subgroup versus the other subgroups. There was no correlation between FDG and RGD PET parameters in the overall group. Only the ER/PR-,Her2- subgroup showed a significant positive correlation between FDG and RGD PET parameters (r = 0.59, p = 0.03 for SUVmax).

CONCLUSION

(68)Ga-RGD and (18)F-FDG PET/CT are promising functional imaging modalities for predicting biomarkers and molecular phenotypes in breast cancer patients.

摘要

目的

评估功能成像模式下的成像生物标志物作为疾病状态潜在替代标志物的可能性。具体而言，在这项前瞻性研究中，我们调查了功能成像参数与组织学预后因素及乳腺癌亚型之间的关系。

方法

共分析了43例患有大的或局部晚期浸润性导管癌（IDC）的患者（年龄47.6±7.5岁）。进行了（68）Ga标记的精氨酸 - 甘氨酸 - 天冬氨酸（RGD）和（18）F - 氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）检查。使用的成像参数为RGD PET/CT的最大和平均标准化摄取值（SUVmax和SUVavg）以及FDG PET/CT的SUVmax和SUVavg。对于组织学预后因素，采用免疫组织化学（IHC）或荧光原位杂交（FISH）鉴定雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER2）的表达。基于ER/PR和HER2表达情况（ER/PR +，Her2 -，ER/PR +，Her2 +，ER/PR -，Her2 +，以及ER/PR -，Her2 -）考虑四种乳腺癌亚型。

结果

定量FDG PET参数在ER阴性组（SUVmax：15.88±8.73 vs 10.48±6.01，p = 0.02；SUVavg：9.40±5.19 vs 5.92±4.09，p = 0.02）和PR阴性组（SUVavg：8.37±4.94 vs 4.79±3.93，p = 0.03）中显著更高。定量RGD PET参数在HER2阳性组（SUVmax：2.42±0.59 vs 2.90±0.75，p = 0.04；SUVavg：1.60±0.38 vs 1.95±0.53，p = 0.04）中显著更高，并且与HER2/CEP17比值呈显著正相关（SUVmax：r = 0.38，p = 0.03；SUVavg：r = 0.46，p < 0.01）。与ER/PR +，Her2 - 或ER/PR +，Her2 + 亚组相比，FDG PET参数在ER/PR -，Her2 - 亚组中显示出显著更高的值，而与其他亚组相比，RGD PET参数在ER/PR -，Her2 - 亚组中显示出显著更低的值。在总体组中，FDG和RGD PET参数之间无相关性。仅ER/PR -，Her2 - 亚组显示FDG和RGD PET参数之间存在显著正相关（SUVmax：r = 0.59，p = 0.03）。