Medina-Ornelas Sevastian, García-Perez Franciso, Estrada-Lobato Enrique, Ochoa-Carrillo Francisco
Departament of Nuclear Medicine and Molecular Imaging, Instituto Nacional de Cancerología Mexico City, Mexico.
Human Health Department International Atomic Energy Agency (IAEA) Viena, Austria.
Am J Nucl Med Mol Imaging. 2020 Jun 15;10(3):135-142. eCollection 2020.
Current research indicates that prostate-specific membrane antigen (PSMA) is related to angiogenesis of many solid tumors including breast cancer (BC), our objective is evaluating PSMA expression in primary tumor and metastatic BC by Positron emission tomography/computed tomography (PET/CT). In this retrospective study twenty-one patients with BC included all molecular subtypes, was evaluated with F-FDG-PET/CT imaging as stratification and Ga-PSMA-PET/CT. Primary sites of BC was identifying in all patients with F-FDG-PET/CT. We identified lymph node metastases in 17 patients (81%) and metastatic disease in 15 patients (71%). A total 127 lesions were detected by F-FDG-PET/CT, 30 of which were in the breast, 31 axillary lymph-node metastases, 25 mediastinal lymph-node metastases, 15 distant non-bone metastases and 26 bone metastases. Ga-PSMA-11-PET/CT showed lower detection-rate (DRs) than did F-FDG-PET/CT in all patients with LUM-A and LUM-B HER2. All F-FDG PET/CT positive lesions in patients TPN (local, lymph nodes, and metastatic lesions) showed Ga-PSMA-PET/CT uptake (P<0.05). Sensitivities and specificities of 99.2% and 93.6% for F-FDG-PET/CT and for Ga-PSMA-11-PET/CT of 84% and 91.8% (P<0.05). Accuracy measured as AUC was 0.86-0.95 in F-FDG-PET/CT and 0.74-0.94 for Ga-PSMA-PET/CT (P<0.05). In Patient-Based analysis we found that patients triple-negative subtype (TPN) evaluated with Ga-PSMA-PET/CT identified a higher number of positive patients than did LUM A. We conclude that a significate DRs to imaging with Ga-PSMA-PET/CT in the staging of locally advanced and metastatic BC with high rates in patients TPN, LUM B HER2 and HER2 overexpression. We believe that concept of theranostics it may be considered as a potential diagnostic and therapeutic target.
当前研究表明，前列腺特异性膜抗原（PSMA）与包括乳腺癌（BC）在内的许多实体瘤的血管生成有关，我们的目标是通过正电子发射断层扫描/计算机断层扫描（PET/CT）评估原发性肿瘤和转移性BC中PSMA的表达。在这项回顾性研究中，纳入了21例涵盖所有分子亚型的BC患者，以F-FDG-PET/CT成像作为分层手段，并进行了Ga-PSMA-PET/CT检查。所有患者均通过F-FDG-PET/CT确定了BC的原发部位。我们在17例患者（81%）中发现了淋巴结转移，在15例患者（71%）中发现了转移性疾病。F-FDG-PET/CT共检测到127个病灶，其中30个位于乳腺，31个为腋窝淋巴结转移，25个为纵隔淋巴结转移，15个为远处非骨转移，26个为骨转移。在所有LUM-A和LUM-B HER2患者中，Ga-PSMA-11-PET/CT的检测率（DRs）低于F-FDG-PET/CT。所有TPN（局部、淋巴结和转移性病灶）患者的F-FDG PET/CT阳性病灶均显示Ga-PSMA-PET/CT摄取（P<0.05）。F-FDG-PET/CT的敏感性和特异性分别为99.2%和93.6%，Ga-PSMA-11-PET/CT的敏感性和特异性分别为84%和91.8%（P<0.05）。以AUC衡量的F-FDG-PET/CT准确性为0.86-0.95，Ga-PSMA-PET/CT的准确性为0.74-0.94（P<0.05）。在基于患者的分析中，我们发现，与LUM A相比，接受Ga-PSMA-PET/CT评估的三阴性亚型（TPN）患者中，阳性患者数量更多。我们得出结论，对于局部晚期和转移性BC分期，Ga-PSMA-PET/CT成像具有显著的DRs，在TPN、LUM B HER2和HER2过表达患者中比例较高。我们认为，治疗诊断学的概念可被视为一个潜在的诊断和治疗靶点。
