免疫组织化学标志物与肺癌的分级之间是否存在联系，以及表观扩散系数（ADC）和混合 18F-FDG-PET/MRI 的标准化摄取值（SUV）？

Is there a connection between immunohistochemical markers and grading of lung cancer with apparent diffusion coefficient (ADC) and standardised uptake values (SUV) of hybrid 18F-FDG-PET/MRI?

机构信息

Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany.

Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.

出版信息

J Med Imaging Radiat Oncol. 2020 Dec;64(6):779-786. doi: 10.1111/1754-9485.13087. Epub 2020 Jul 24.

DOI:10.1111/1754-9485.13087

PMID:32705779

Abstract

INTRODUCTION

To correlate tumour grading and prognostic immunohistochemical markers of lung cancer with simultaneously acquired standardised uptake values (SUV) and apparent diffusion coefficient (ADC) derived from hybrid PET/MRI.

METHODS

In this retrospective study, 55 consecutive patients (mean age 62.5 ± 9.2 years) with therapy-naïve, histologically proven lung cancer were included. All patients underwent whole-body PET/MRI using 18F-flourdeoxyglucose (18F-FDG) as a radiotracer. Diffusion-weighted imaging of the chest (DWI, b-values: 0, 500, 1000 s/mm ) was performed simultaneously with PET acquisition. Histopathological tumour grading was available in 43/55 patients. In 15/55 patients, immunohistochemical markers, that is, phospho-AKT Ser473 (pAKTS473), phosphorylated extracellular signal-regulated kinase (pERK), phosphatase and tensin homolog (PTEN), and human epidermal growth factor receptor 2 (erbB2) were available.

RESULTS

The average SUVmax, SUVmean, ADCmin and ADCmean in lung cancer primaries were 12.6 ± 5.9, 7.7 ± 4.6, 569.9 ± 96.1 s/mm and 825.8 ± 93.2 s/mm , respectively. We found a significant inverse correlation between the ADCmin and SUVmax (r = -0.58, P < 0.001) as well as between the ADCmin and SUVmean (r = -0.44, P < 0.001). Tumour grading showed a significant positive correlation with SUVmax and SUVmean (R = 0.34 and R = 0.31, both P < 0.05) and a significant inverse correlation with ADCmin and ADCmean (r = -0.30 and r = -0.40, both P < 0.05). In addition, erbB2 showed a significant inverse correlation with SUVmax and SUVmean (r = -0.50 and r = -0.49, both P < 0.05). The other immunohistochemical markers did not show any significant correlation.

CONCLUSION

18F-FDG-PET/MRI showed weak to moderate correlations between SUV, ADC, tumour grading and erbB2-expression of lung cancer. Hence, 18F-FDG-PET/MRI may, to some extent, offer complementary information to the histopathology of lung cancer, for the evaluation of tumour aggressiveness and treatment response.

摘要

简介

本研究旨在探讨肺癌肿瘤分级和预后免疫组织化学标志物与同时获取的标准化摄取值（SUV）和来自杂交 PET/MRI 的表观扩散系数（ADC）之间的相关性。

方法

本回顾性研究纳入了 55 例经组织学证实的、未经治疗的原发性肺癌患者（平均年龄 62.5±9.2 岁）。所有患者均接受了 18F-氟脱氧葡萄糖（18F-FDG）作为示踪剂的全身 PET/MRI 检查。同时进行胸部弥散加权成像（DWI，b 值：0、500、1000 s/mm）。在 43/55 例患者中获得了组织病理学肿瘤分级。在 15/55 例患者中，获得了免疫组织化学标志物，即磷酸化 AKT 丝氨酸 473 （pAKTS473）、磷酸化细胞外信号调节激酶（pERK）、磷酸酶和张力蛋白同源物（PTEN）和人表皮生长因子受体 2（erbB2）。

结果

肺癌原发灶的平均 SUVmax、SUVmean、ADCmin 和 ADCmean 分别为 12.6±5.9、7.7±4.6、569.9±96.1 s/mm 和 825.8±93.2 s/mm。我们发现 ADCmin 与 SUVmax（r=-0.58，P<0.001）以及 ADCmin 与 SUVmean（r=-0.44，P<0.001）之间存在显著的负相关。肿瘤分级与 SUVmax 和 SUVmean 呈显著正相关（R=0.34 和 R=0.31，均 P<0.05），与 ADCmin 和 ADCmean 呈显著负相关（r=-0.30 和 r=-0.40，均 P<0.05）。此外，erbB2 与 SUVmax 和 SUVmean 之间呈显著负相关（r=-0.50 和 r=-0.49，均 P<0.05）。其他免疫组织化学标志物之间未显示出任何显著相关性。