Liu Hao, Chen Yao, Wu Shuang, Song Fahuan, Zhang Hong, Tian Mei
aDepartment of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine bZhejiang University Medical PET Center cInstitute of Nuclear Medicine and Molecular Imaging, Zhejiang University dKey Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
Nucl Med Commun. 2016 Nov;37(11):1116-24. doi: 10.1097/MNM.0000000000000576.
Breast cancer is a major disease with high morbidity and mortality in women. As a highly heterogeneous tumor, it contains different molecular subtypes: luminal A, luminal B, human epidermal growth factor 2-positive, and triple-negative subtypes. As each subtype has unique features, it may not be universal to the optimal treatment and expected response for individual patients. Therefore, it is critical to identify different breast cancer subtypes. Targeting subcellular levels, molecular imaging, especially PET and single photon emission computed tomography, has become a promising means to identify breast cancer subtypes and monitor treatment. Different biological processes between various subtypes, including changes correlated with receptor expression, cell proliferation, or glucose metabolism, have the potential for imaging with PET and single photon emission computed tomography radiopharmaceuticals. Receptor imaging, with radiopharmaceuticals targeting estrogen receptor, progesterone receptor, or human epidermal growth factor 2, is available to distinguish receptor-positive tumors from receptor-negative ones. Cell proliferation imaging with fluorine-18 fluorothymidine PET aids identification of luminal A and B subtypes on the basis of the correlation with the immunohistochemical biomarker Ki-67. Glucose metabolism imaging with fluorine-18 fluorodeoxyglucose PET may have potential to discriminate triple-negative subtypes from others. With increasing numbers of novel radiopharmaceuticals, noninvasive molecular imaging will be applied widely for the identification of different subtypes and provide more in-vivo information on individualized management of breast cancer patients.
乳腺癌是一种在女性中发病率和死亡率都很高的重大疾病。作为一种高度异质性肿瘤，它包含不同的分子亚型：腔面A型、腔面B型、人表皮生长因子2阳性型和三阴性亚型。由于每种亚型都有独特的特征，对于个体患者的最佳治疗和预期反应可能并不通用。因此，识别不同的乳腺癌亚型至关重要。针对亚细胞水平，分子成像，尤其是正电子发射断层扫描（PET）和单光子发射计算机断层扫描，已成为识别乳腺癌亚型和监测治疗的一种有前景的手段。不同亚型之间的不同生物学过程，包括与受体表达、细胞增殖或葡萄糖代谢相关的变化，都有可能用PET和单光子发射计算机断层扫描放射性药物进行成像。利用靶向雌激素受体、孕激素受体或人表皮生长因子2的放射性药物进行受体成像，可区分受体阳性肿瘤和受体阴性肿瘤。用氟-18氟胸苷PET进行细胞增殖成像，有助于根据与免疫组化生物标志物Ki-67的相关性识别腔面A型和B型亚型。用氟-18氟脱氧葡萄糖PET进行葡萄糖代谢成像可能有潜力将三阴性亚型与其他亚型区分开来。随着新型放射性药物数量的增加，非侵入性分子成像将被广泛应用于不同亚型的识别，并为乳腺癌患者的个体化管理提供更多体内信息。
