使用 F-FDG PET/CT 检测可手术的三阴性乳腺癌腋窝淋巴结代谢和容积参数预测乳腺癌复发。
Prediction of breast cancer recurrence using lymph node metabolic and volumetric parameters from F-FDG PET/CT in operable triple-negative breast cancer.
机构信息
Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.
出版信息
Eur J Nucl Med Mol Imaging. 2017 Oct;44(11):1787-1795. doi: 10.1007/s00259-017-3748-7. Epub 2017 Jun 14.
PURPOSE
Triple-negative breast cancer has a poor prognosis. We evaluated several metabolic and volumetric parameters from preoperative F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the prognosis of triple-negative breast cancer and compared them with current clinicopathologic parameters.
METHODS
A total of 228 patients with triple-negative breast cancer (mean age 47.0 ± 10.8 years, all women) who had undergone preoperative PET/CT were included. The PET/CT metabolic parameters evaluated included maximum, peak, and mean standardized uptake values (SUVmax, SUVpeak, and SUVmean, respectively). The volumetric parameters evaluated included metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Metabolic and volumetric parameters were evaluated separately for tumor (T) and lymph nodes (N). The prognostic value of these parameters was compared with that of clinicopathologic parameters.
RESULTS
All lymph node metabolic and volumetric parameters showed significant differences between patients with and without recurrence. However, tumor metabolic and volumetric parameters showed no significant differences. In a univariate survival analysis, all lymph node metabolic and volumetric parameters (SUVmax-N, SUVpeak-N, SUVmean-N, MTV-N, and TLG-N; all P < 0.001), T stage (P = 0.010), N stage (P < 0.001), and TNM stage (P < 0.001) were significant parameters. In a multivariate survival analysis, SUVmax-N (P = 0.005), MTV (P = 0.008), and TLG (P = 0.006) with TNM stage (all P < 0.001) were significant parameters.
CONCLUSIONS
Lymph node metabolic and volumetric parameters were significant predictors of recurrence in patients with triple-negative breast cancer after surgery. Lymph node metabolic and volumetric parameters were useful parameters for evaluating prognosis in patients with triple-negative breast cancer by F-FDG PET/CT, rather than tumor parameters.
目的
三阴性乳腺癌预后较差。我们评估了来自术前 F-氟代脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）的几种代谢和容积参数在三阴性乳腺癌预后中的作用，并将其与当前的临床病理参数进行了比较。
方法
共纳入 228 例三阴性乳腺癌患者（平均年龄 47.0±10.8 岁，均为女性），均接受了术前 PET/CT 检查。评估的 PET/CT 代谢参数包括最大标准摄取值（SUVmax）、峰值（SUVpeak）和平均标准摄取值（SUVmean）。评估的容积参数包括代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。分别评估肿瘤（T）和淋巴结（N）的代谢和容积参数。比较这些参数与临床病理参数的预后价值。
结果
所有淋巴结代谢和容积参数在有和无复发的患者之间均有显著差异。然而，肿瘤代谢和容积参数无显著差异。在单因素生存分析中，所有淋巴结代谢和容积参数（SUVmax-N、SUVpeak-N、SUVmean-N、MTV-N 和 TLG-N；均 P<0.001）、T 分期（P=0.010）、N 分期（P<0.001）和 TNM 分期（P<0.001）均为显著参数。在多因素生存分析中，SUVmax-N（P=0.005）、MTV（P=0.008）和 TLG（P=0.006）与 TNM 分期（均 P<0.001）是显著参数。
结论
淋巴结代谢和容积参数是三阴性乳腺癌患者手术后复发的重要预测指标。与肿瘤参数相比，FDG PET/CT 中的淋巴结代谢和容积参数是评估三阴性乳腺癌患者预后的有用参数。
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