Pan Jingying, He Mengye, Ke Wei, Hu Menglin, Wang Meifang, Shen Peng
Department of Medical Oncology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2017 May 25;46(5):473-480. doi: 10.3785/j.issn.1008-9292.2017.10.04.
In recent years, PET-CT has an increasing importance in the diagnosis and treatment of breast cancer. PET-CT scan can be used as a noninvasive method for molecular subtyping of breast cancer, and prediction of therapeutic effect and prognosis of patients. Studies have revealed that luminal A subtype has a significantly lower maximum standard intake value (SUVmax) than the other subtypes; triple-negative and human epidermal growth factor receptor 2 (HER2) positive tumors have relatively high SUVmax than luminal B subtype, but the specificity and sensitivity of SUVmax in diagnosis of molecular subtypes are very low, so its clinical application is limited. In predicting the effectiveness of the treatment and the prognosis of the patients, the decreased uptake of fluorodeoxyglucose (FDG) is correlated with better therapeutic effect. In addition, patients with high FDG uptake have worse survival outcomes. New tracers, such as F-fluoroestradiol (F-FES) and[89Zr]trastuzumab play an important role in molecular subtyping of breast cancer. F-FES PET-CT can effectively evaluate the estrogen receptor (ER) status of breast cancer and the response to endocrine therapy.[89Zr]trastuzumab PET-CT can evaluate the expression of HER2 and localization of HER2-overexpressing tumors, but their specificities and sensitivities are also low. In this article, we review the recent advances on the correlation of PET-CT findings with molecular subtypes, treatment response and prognosis of breast cancer.
近年来,正电子发射断层显像-X线计算机体层成像(PET-CT)在乳腺癌的诊断和治疗中愈发重要。PET-CT扫描可作为一种用于乳腺癌分子分型、预测患者治疗效果及预后的非侵入性方法。研究显示,管腔A型亚型的最大标准摄取值(SUVmax)显著低于其他亚型;三阴性及人表皮生长因子受体2(HER2)阳性肿瘤的SUVmax相较于管腔B型亚型相对较高,但SUVmax在分子亚型诊断中的特异性和敏感性很低,因此其临床应用受限。在预测治疗效果及患者预后方面,氟脱氧葡萄糖(FDG)摄取降低与较好的治疗效果相关。此外,FDG摄取高的患者生存结局较差。新型示踪剂,如F-氟雌二醇(F-FES)和[89Zr]曲妥珠单抗在乳腺癌分子分型中发挥重要作用。F-FES PET-CT可有效评估乳腺癌的雌激素受体(ER)状态及对内分泌治疗的反应。[89Zr]曲妥珠单抗PET-CT可评估HER2的表达及HER2过表达肿瘤的定位,但它们的特异性和敏感性也较低。在本文中,我们综述了PET-CT检查结果与乳腺癌分子亚型、治疗反应及预后相关性的最新进展。