Chiacchio Serena, Evangelista Laura, Alsharif Abedallatif, Manca Gianpiero, DI Martino Fabio, Negri Anna, Tredici Manuel, Cervino Anna R, Puccini Giulia, Filidei Elena, Ghilli Matteo, Naccarato Antonio G, Roncella Manuela, Volterrani Duccio
Regional Center of Nuclear Medicine, Department of Diagnostic Radiology and Vascular Radiology and Interventional and Nuclear Medicine, University Hospital of Pisa, Pisa, Italy -
Unit of Radiotherapy and Nuclear Medicine, Istituto Oncologico Veneto (IOV), IRCC, Padua, Italy.
Q J Nucl Med Mol Imaging. 2018 Mar;62(1):101-111. doi: 10.23736/S1824-4785.17.02810-2. Epub 2015 Sep 1.
Molecular subtypes of breast cancer have been proposed since 2012. The correlation between various baseline [18F]fluorodeoxyglucose ([18F]FDG) uptake parameters, including total lesion glycolysis (TLG), and molecular subtypes of primary breast cancer lesions in patients with invasive ductal cancer will be investigated.
Staging [18F]FDG PET/CT for breast invasive ductal carcinoma were retrospectively evaluated. Breast lesions were examined for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and proliferation index (Ki-67). Breast tumors were classified into five molecular subtypes: Luminal A, Luminal B-HER2(-), Luminal B-HER2(+), HER2(+) and Basal or Triple Negative cancers. The correlations between tumor characteristics and PET semiquantitative data of primary breast lesion (SUVmean, SUVmax, Mean tumor volume (MTV), TLG) were assessed. Specific Breast Uptake Ratio (SBUR) is used as a new quantification method of breast uptake to correct for physiological background activity.
Fifty-eight patients were included. TLG was significantly higher in triple negative group when compared with luminal A (P<0.01). Significantly higher uptake was found in triple negative lesions when compared with luminal B-HER2(-) and luminal B-HER2(+) categories using SUVmax, SUVmean and TLG (all P<0.05). Conversely, no statistically significant difference for [18F]FDG uptake was observed between all other molecular subtypes. No value of SBUR in terms of correlation with histopathological parameters was demonstrated.
TLG was superior to SUVmax and SUVmean in differentiating between triple negative breast cancer lesions and all other molecular subtypes. SBUR was not different statistically between various molecular subtypes.
自2012年起提出了乳腺癌的分子亚型。本研究将调查包括总病变糖酵解（TLG）在内的各种基线[18F]氟脱氧葡萄糖（[18F]FDG）摄取参数与浸润性导管癌患者原发性乳腺癌病变分子亚型之间的相关性。
对乳腺癌浸润性导管癌的分期[18F]FDG PET/CT进行回顾性评估。检测乳腺病变的雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER2）和增殖指数（Ki-67）。乳腺肿瘤分为五种分子亚型：Luminal A、Luminal B-HER2（-）、Luminal B-HER2（+）、HER2（+）以及基底型或三阴性癌。评估肿瘤特征与原发性乳腺病变PET半定量数据（SUVmean、SUVmax、平均肿瘤体积（MTV）、TLG）之间的相关性。采用特定乳腺摄取率（SBUR）作为一种新的乳腺摄取定量方法来校正生理本底活性。
纳入58例患者。三阴性组的TLG显著高于Luminal A组（P<0.01）。使用SUVmax、SUVmean和TLG时，三阴性病变的摄取显著高于Luminal B-HER2（-）和Luminal B-HER2（+）类别（均P<0.05）。相反，在所有其他分子亚型之间未观察到[18F]FDG摄取的统计学显著差异。未证实SBUR与组织病理学参数之间存在相关性。
在区分三阴性乳腺癌病变与所有其他分子亚型方面，TLG优于SUVmax和SUVmean。不同分子亚型之间的SBUR在统计学上无差异。
