FDG-PET/CT在预测针吸活检诊断为导管原位癌的病例中浸润性乳腺癌低估情况中的作用。
Role of FDG-PET/CT in prediction of underestimation of invasive breast cancer in cases of ductal carcinoma in situ diagnosed at needle biopsy.
作者信息
Shigematsu Hideo, Kadoya Takayuki, Masumoto Norio, Matsuura Kazuo, Emi Akiko, Kajitani Keiko, Amioka Ai, Okada Morihito
机构信息
Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
出版信息
Clin Breast Cancer. 2014 Oct;14(5):358-64. doi: 10.1016/j.clbc.2014.04.006. Epub 2014 Jun 2.
BACKGROUND
The aim of this study was to evaluate the significance of FDG-PET/CT for predicting the underestimation of invasive breast cancer in cases of DCIS at needle biopsy.
PATIENTS AND METHODS
Of 83 consecutive cases with diagnoses of DCIS at primary needle biopsy who underwent curative surgery between 2010 and 2013, the association between the SUVmax on FDG-PET/CT before excision and the underestimation of invasive breast cancer was examined.
RESULTS
There were 29 (34.9%) cases diagnosed to have invasive breast cancer at excision. Receiver operating characteristics curve analysis showed the cutoff value of the SUVmax to predict underestimation of invasive breast cancer was 1.6. The rates of underestimation were 61.5% for patients with a tumor of SUVmax > 1.6 and 11.4% for patients with a tumor of SUVmax ≤ 1.6 (P < .001). A high value of SUVmax was significantly associated with symptomatic presentation (P < .001), palpability (P < .001), mass formation (P = .013), high Breast Imaging Reporting and Data System category (P = .011), and core needle biopsy (P = .007). In multivariate analysis, high SUVmax was only a significant predictive factor of underestimation of invasive breast cancer (hazard ratio, 11.7; 95% confidence interval, 3.70-37.0; P < .001).
CONCLUSION
SUVmax on FDG-PET/CT is useful for predicting the underestimation of invasive breast cancer in cases of DCIS at needle biopsy.
背景
本研究的目的是评估氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（FDG-PET/CT）在预测针吸活检诊断为导管原位癌（DCIS）的病例中浸润性乳腺癌被低估情况的意义。
患者与方法
在2010年至2013年间接受根治性手术的83例初次针吸活检诊断为DCIS的连续病例中，研究了切除术前FDG-PET/CT上的最大标准摄取值（SUVmax）与浸润性乳腺癌被低估之间的关联。
结果
有29例（34.9%）在切除时被诊断为浸润性乳腺癌。受试者工作特征曲线分析显示，预测浸润性乳腺癌被低估的SUVmax临界值为1.6。SUVmax＞1.6的肿瘤患者被低估的发生率为61.5%，而SUVmax≤1.6的肿瘤患者为11.4%（P＜0.001）。SUVmax高值与有症状表现（P＜0.001）、可触及（P＜0.001）、形成肿块（P = 0.013）、乳腺影像报告和数据系统（BI-RADS）分类高（P = 0.011）以及粗针活检（P = 0.007）显著相关。在多变量分析中，高SUVmax仅是浸润性乳腺癌被低估的显著预测因素（风险比，11.7；95%置信区间，3.70 - 37.0；P＜0.001）。
结论
FDG-PET/CT上的SUVmax有助于预测针吸活检诊断为DCIS的病例中浸润性乳腺癌被低估的情况。
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