Hyun Seung Hyup, Ahn Hee Kyung, Lee Joo Hee, Choi Joon Young, Kim Byung-Tae, Park Yeon Hee, Im Young-Hyuck, Lee Jeong Eon, Nam Seok Jin, Lee Kyung-Han
Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
PLoS One. 2016 Oct 31;11(10):e0165814. doi: 10.1371/journal.pone.0165814. eCollection 2016.
To investigate the combined prognostic impact of body mass index (BMI) and tumor standardized uptake value (SUV) measured on pretreatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients with breast cancer.
We evaluated a cohort of 332 patients with newly diagnosed breast cancer (stage I-III) who underwent pretreatment FDG PET/CT followed by curative resection. Patients were categorized as overweight (BMI ≥ 23 kg/m2) or normal weight (BMI < 23 kg/m2). Primary tumor maximum SUV was measured by FDG PET/CT. Associations between BMI and tumor SUV with disease recurrence were assessed using Cox regression models.
Median follow-up was 39 months. There were 76 recurrences and 15 cancer-related deaths. Multivariable Cox regression analysis demonstrated that high tumor SUV (hazard ratio [HR] = 1.75; 95% CI, 1.02-3.02; P = 0.044) and overweight (HR = 1.84; 95% CI, 1.17-2.89; P = 0.008) were independent poor prognostic factors. Positive hormone receptor status was an independent predictor of favorable outcome (HR = 0.42; 95% CI, 0.26-0.68; P < 0.001). Overweight patients with high tumor SUV had a two-fold risk of recurrence compared to patients with normal weight or low tumor SUV after adjusting for clinical stage and tumor subtype (HR = 2.06; 95% CI, 1.30-3.27; P = 0.002).
In patients with breast cancer, higher tumor SUV was associated with a more adverse outcome particularly in overweight women. BMI status combined with tumor SUV data allows better risk-stratification of breast cancer, independent of clinical stage and tumor subtype.
探讨体重指数（BMI）和肿瘤标准化摄取值（SUV）在乳腺癌患者治疗前18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）上的联合预后影响。
我们评估了一组332例新诊断的乳腺癌患者（I-III期），这些患者在接受FDG PET/CT治疗前进行了根治性切除。患者被分为超重（BMI≥23 kg/m2）或正常体重（BMI<23 kg/m2）。通过FDG PET/CT测量原发性肿瘤最大SUV。使用Cox回归模型评估BMI和肿瘤SUV与疾病复发之间的关联。
中位随访时间为39个月。有76例复发和15例癌症相关死亡。多变量Cox回归分析表明，高肿瘤SUV（风险比[HR]=1.75；95%CI，1.02-3.02；P=0.044）和超重（HR=1.84；95%CI，1.17-2.89；P=0.008）是独立的不良预后因素。激素受体阳性状态是良好预后的独立预测因素（HR=0.42；95%CI，0.26-0.68；P<0.001）。在调整临床分期和肿瘤亚型后，超重且肿瘤SUV高的患者复发风险是正常体重或肿瘤SUV低的患者的两倍（HR=2.06；95%CI，1.30-3.27；P=0.002）。
在乳腺癌患者中，较高的肿瘤SUV与更差的预后相关，尤其是在超重女性中。BMI状态与肿瘤SUV数据相结合可以更好地对乳腺癌进行风险分层，独立于临床分期和肿瘤亚型。
