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乳腺癌中 F-FDG PET/CT 代谢参数与临床病理因素及预后的相关性。

The correlation of F-FDG PET/CT metabolic parameters, clinicopathological factors, and prognosis in breast cancer.

机构信息

Department of Medical Imaging, The Affiliated Yantai Yuhuangding Hospital of Qindao University, No. 20 Yuhuangding East Road, Zhifu District, Yantai, 264000, China.

出版信息

Clin Transl Oncol. 2021 Mar;23(3):620-627. doi: 10.1007/s12094-020-02457-w. Epub 2020 Jul 18.

Abstract

PURPOSE

To study the imaging parameters of F-fluorodeoxy glucose (F-FDG) in breast cancer on positron emission tomography/computed tomography (PET/CT)-the correlation of clinical pathological factors and prognosis among the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of lesions for patients.

METHODS

From January 2012 to December 2014, a total of 125 female patients were treated in our hospital for the first time and were diagnosed as breast cancer by histopathology. They were selected as the research subjects. All of them had complete F-FDG PET/CT examination data before surgery, the postoperative clinicopathological information, and follow-up data. They were divided into the event group (38 cases) and the event-free group (87 cases) according to whether local recurrence or distant metastasis occurred after the follow-up, with the follow-up time 4-60 months. The correlation on F-FDG PET/CT metabolic parameters of breast cancer with clinicopathological factors and prognosis was retrospectively evaluated.

RESULTS

The primary lesions of 125 cases with breast cancers all had higher F-FDG uptake, and the SUVmax, MTV, and TLG of the primary tumors in the event group were significantly higher than those in the event-free group (t = 2.645, 2.782, 15.263, p = 0.011, 0.008, 0.000), p < 0.05; SUVmax, MTV, and TLG of primary breast cancer have no correlation with age and tumor site of patient (p > 0.05); there were statistically significant differences in the SUVmax, MTV, and TLG of primary tumor in the comparison of different tumor size, T stage, N stage, and histological grades (p < 0.05); all of SUVmax, MTV, and TLG in the estrogen receptor (ER) and/or progesterone receptor (PR) positive groups were lower than those in the negative group, with statistically significant difference (p < 0.05); the SUVmax, MTV, and TLG of human epidermal growth factor receptor 2 (HER2) positive group, proliferating cell nuclear antigen (Ki-67) high expression group were higher than those in the negative group and low expression group, with statistically significant difference (p < 0.05). There were 38 recurrence and metastasis cases within 125 cases with breast cancer in 5 years after operation, with the total recurrence and metastasis rate as 30.40% (38/125). The event-free survival rate in the SUVmax ≥ 8.64 group was significantly lower than that in the SUVmax < 8.64 group (p < 0.01).

CONCLUSIONS

The metabolic parameters of F-FDG PET/CT in breast cancer can reflect the biological behavior of the tumor indirectly; therefore, it was studied on the related correlation to provide the guidance of clinical individualized comprehensive treatment and prognostic judgment.

摘要

目的

研究正电子发射断层扫描/计算机断层扫描(PET/CT)中氟-18 氟代脱氧葡萄糖(F-FDG)在乳腺癌中的成像参数,探讨病灶最大标准化摄取值(SUVmax)、代谢肿瘤体积(MTV)和总病变糖酵解(TLG)与患者临床病理因素和预后的相关性。

方法

选取 2012 年 1 月至 2014 年 12 月期间在我院首次治疗并经组织病理学诊断为乳腺癌的 125 例女性患者为研究对象。所有患者均在术前完成完整的 F-FDG PET/CT 检查,术后获得临床病理信息及随访资料。根据随访后是否发生局部复发或远处转移,将患者分为事件组(38 例)和无事件组(87 例),随访时间为 4-60 个月。回顾性分析乳腺癌 F-FDG PET/CT 代谢参数与临床病理因素及预后的相关性。

结果

125 例乳腺癌原发灶 F-FDG 摄取均较高,事件组原发肿瘤的 SUVmax、MTV 和 TLG 均显著高于无事件组(t=2.645、2.782、15.263,p=0.011、0.008、0.000),p<0.05;SUVmax、MTV 和 TLG 与患者年龄和肿瘤部位无相关性(p>0.05);不同肿瘤大小、T 分期、N 分期和组织学分级的原发肿瘤 SUVmax、MTV 和 TLG 比较,差异均有统计学意义(p<0.05);雌激素受体(ER)和/或孕激素受体(PR)阳性组的 SUVmax、MTV 和 TLG 均低于阴性组,差异有统计学意义(p<0.05);人表皮生长因子受体 2(HER2)阳性组、增殖细胞核抗原(Ki-67)高表达组的 SUVmax、MTV 和 TLG 均高于阴性组和低表达组,差异有统计学意义(p<0.05)。125 例乳腺癌患者术后 5 年内有 38 例复发转移,总复发转移率为 30.40%(38/125)。SUVmax≥8.64 组的无事件生存率明显低于 SUVmax<8.64 组(p<0.01)。

结论

乳腺癌 F-FDG PET/CT 代谢参数可间接反映肿瘤的生物学行为,因此对其相关相关性进行研究可为临床个体化综合治疗和预后判断提供指导。

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