Lim Chae Hong, Moon Seung Hwan, Cho Young Seok, Im Young-Hyuck, Choe Yearn Seong, Kim Byung-Tae, Lee Kyung-Han
Department of Nuclear Medicine Department of Internal Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea.
Medicine (Baltimore). 2016 Aug;95(32):e4266. doi: 10.1097/MD.0000000000004266.
Identification of tumor imaging features associated with metastatic pattern may allow better understanding of cancer dissemination. Here, we investigated how primary tumor F-fluorodeoxyglucose (FDG) avidity influences the first site of breast cancer metastasis.Subjects were 264 patients with advanced breast cancer who underwent positron emission tomography/computed tomography at diagnosis and had metastasis at presentation (n = 193) or metastatic relapse after surgery (n = 71). Primary tumor FDG avidity (maximum SUV [SUVmax] ≥10.1) was compared with histology and first metastatic sites.The most common site of first metastasis was the bone, occurring in 62.7% of patients with metastasis at presentation and 38.0% of those with metastatic relapse. First metastasis to lung occurred in 30.1% and 35.2%, and to liver in 25.4% and 15.2% of respective groups. In patients with metastasis at presentation, primary tumors were FDG avid in 98/193 cases, and this was associated with more frequent first metastasis to lung (37.8% vs 22.1%; P = 0.018). In patients with metastasis relapse, primary tumors were FDG avid in 31/71 cases, and this was associated with more frequent first metastasis to lung (48.4% vs 25.0%; P = 0.041) and liver (29.0% vs 5.0%; P = 0.008). In patients with metastasis relapse, primary tumors that were FDG avid but hormone receptor negative had more first metastasis to lung (57.9% vs 26.9%; P = 0.016).FDG-avid primary breast tumors have favored first spread to the lung and liver, which suggests that tumor cells with heightened glycolytic activity better colonize these organs.
识别与转移模式相关的肿瘤影像学特征可能有助于更好地理解癌症扩散。在此，我们研究了原发性肿瘤的氟脱氧葡萄糖（FDG）摄取如何影响乳腺癌转移的首个部位。研究对象为264例晚期乳腺癌患者，这些患者在诊断时接受了正电子发射断层扫描/计算机断层扫描，且在就诊时已发生转移（n = 193）或术后发生转移复发（n = 71）。将原发性肿瘤的FDG摄取（最大标准摄取值[SUVmax]≥10.1）与组织学及首个转移部位进行比较。首个转移最常见的部位是骨，在就诊时发生转移的患者中占62.7%，在转移复发的患者中占38.0%。两组中首次转移至肺的分别占30.1%和35.2%，转移至肝的分别占25.4%和15.2%。在就诊时发生转移的患者中，193例中有98例原发性肿瘤为FDG摄取阳性，这与更频繁地首次转移至肺相关（37.8%对22.1%；P = 0.018）。在转移复发的患者中，71例中有31例原发性肿瘤为FDG摄取阳性，这与更频繁地首次转移至肺（48.4%对25.0%；P = 0.041）和肝（29.0%对5.0%；P = 0.008）相关。在转移复发的患者中，FDG摄取阳性但激素受体阴性的原发性肿瘤有更多首次转移至肺的情况（57.9%对26.9%；P = 0.016）。FDG摄取阳性的原发性乳腺肿瘤倾向于首先扩散至肺和肝，这表明糖酵解活性增强的肿瘤细胞更易在这些器官定植。
