Institute of Medical Sciences, School of Medicine, University of Aberdeen, Aberdeen, UK.
Pathology Department, Aberdeen Royal Infirmary, Aberdeen, UK.
Br J Cancer. 2020 Jul;123(2):261-267. doi: 10.1038/s41416-020-0886-7. Epub 2020 May 19.
Precision medicine in breast cancer demands markers sensitive to early treatment response. Aerobic glycolysis (AG) upregulates lactate dehydrogenase A (LDH-A) with elevated lactate production; however, existing approaches for lactate quantification are either invasive or impractical clinically.
Thirty female patients (age 39-78 years, 15 grade II and 15 grade III) with invasive ductal carcinoma were enrolled. Lactate concentration was quantified from freshly excised whole tumours with double quantum filtered (DQF) magnetic resonance spectroscopy (MRS), and Nottingham Prognostic Index (NPI), LDH-A and proliferative marker Ki-67 were assessed histologically.
There was a significantly higher lactate concentration (t = 2.2224, p = 0.0349) in grade III (7.7 ± 2.9 mM) than in grade II (5.5 ± 2.4 mM). Lactate concentration was correlated with NPI (ρ = 0.3618, p = 0.0495), but not with Ki-67 (ρ = 0.3041, p = 0.1023) or tumour size (r = 0.1716, p = 0.3645). Lactate concentration was negatively correlated with LDH-A (ρ = -0.3734, p = 0.0421).
Our results showed that lactate concentration in whole breast tumour from DQF MRS is sensitive to tumour grades and patient prognosis.
乳腺癌精准医学需要对早期治疗反应敏感的标志物。有氧糖酵解（AG）上调乳酸脱氢酶 A（LDH-A），导致乳酸生成增加；然而，现有的乳酸定量方法要么具有侵入性，要么在临床上不切实际。
本研究纳入了 30 名女性浸润性导管癌患者（年龄 39-78 岁，15 级 II 期和 15 级 III 期）。采用双量子过滤（DQF）磁共振波谱（MRS）从新鲜切除的整个肿瘤中定量乳酸浓度，并评估诺丁汉预后指数（NPI）、LDH-A 和增殖标志物 Ki-67 的组织学表现。
III 级肿瘤（7.7±2.9 mM）的乳酸浓度明显高于 II 级肿瘤（5.5±2.4 mM）（t=2.2224，p=0.0349）。乳酸浓度与 NPI 呈正相关（ρ=0.3618，p=0.0495），但与 Ki-67 或肿瘤大小无相关性（ρ=0.3041，p=0.1023；r=0.1716，p=0.3645）。乳酸浓度与 LDH-A 呈负相关（ρ=-0.3734，p=0.0421）。
我们的研究结果表明，DQF MRS 检测的整个乳房肿瘤中的乳酸浓度对肿瘤分级和患者预后敏感。
