Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501 Japan.
Hell J Nucl Med. 2020 Sep-Dec;23(3):272-289. doi: 10.1967/s002449912218.
The prognostic value of harmonized pretreatment volume-based quantitative fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) parameters in metastatic breast cancer patients was investigated.
Records of 65 stage IV breast cancer patients, including 29 estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative, 23 HER2-positive, and 13 triple-negative cases, from four different institutions were retrospectively reviewed. Harmonized standardized uptake value (SUVmax) of the primary tumor (pSUVmax), highest SUVmax of all malignant lesions (wSUVmax), whole-body metabolic tumor volume (WB MTV), and whole-body total lesion glycolysis (WB TLG) shown by pretreatment F-FDG PET/CT imaging were calculated. Cox proportional hazards model and log-rank test results were used to evaluate relationships among clinicopathological factors, volume-based quantitative F-FDG PET/CT parameters, progression-free survival, and overall survival (OS).
Disease progression occurred in 54 patients and 28 died during a median follow-up period of 52.5 months (range 2.6-133.6 months). Univariate analysis of all cases showed associations of negative ER and progesterone receptor (PR) status (P=0.0025), and high T/N stage (P=0.037/P=0.019), pSUVmax (P=0.049), WB MTV (P=0.021), and WB TLG (P=0.0010) with significantly shorter OS. Multivariate analysis confirmed negative ER and PR status (hazard ratio [HR]: 6.42, 95% confidence interval [CI]: 2.27-19.38; P=0.0054), high T stage (HR: 5.10, 95% CI:1.96-18.61, P=0.0064) and WB TLG (HR: 4.69, 95% CI:1.67-12.79, P=0.049) as independent negative OS predictors. In two groups of ER-positive/HER2-negative and triple-negative, WB TLG had a significant association with death (P=0.021 and P=0.037, respectively) on univariate analysis. In a HER2-positive group, no independent negative OS predictors were observed.
In metastatic breast cancer patients, harmonized pretreatment quantitative volume-based F-FDG PET/CT parameters, especially whole-body TLG, are potential surrogate markers for prognosis.
研究基于预处理容积的氟-18-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）参数在转移性乳腺癌患者中的预后价值。
回顾性分析了来自四个不同机构的 65 例 IV 期乳腺癌患者（29 例雌激素受体[ER]阳性/人表皮生长因子受体 2 [HER2]阴性，23 例 HER2 阳性，13 例三阴性）的病历记录。计算了原发肿瘤的标准化摄取值最大（pSUVmax）、所有恶性病变的最大摄取值（wSUVmax）、全身代谢肿瘤体积（WB MTV）和全身总病变糖酵解（WB TLG）。使用 Cox 比例风险模型和对数秩检验结果来评估临床病理因素、基于容积的定量 F-FDG PET/CT 参数、无进展生存期和总生存期（OS）之间的关系。
在中位随访期 52.5 个月（范围 2.6-133.6 个月）期间，54 例患者出现疾病进展，28 例患者死亡。对所有病例的单因素分析显示，ER 和孕激素受体（PR）阴性状态（P=0.0025）以及高 T/N 分期（P=0.037/P=0.019）、pSUVmax（P=0.049）、WB MTV（P=0.021）和 WB TLG（P=0.0010）与 OS 显著缩短相关。多因素分析证实 ER 和 PR 阴性状态（风险比[HR]：6.42，95%置信区间[CI]：2.27-19.38；P=0.0054）、高 T 分期（HR：5.10，95% CI：1.96-18.61，P=0.0064）和 WB TLG（HR：4.69，95% CI：1.67-12.79，P=0.049）是独立的 OS 负相关预测因子。在 ER 阳性/HER2 阴性和三阴性两组中，WB TLG 与死亡有显著关联（单因素分析 P=0.021 和 P=0.037）。在 HER2 阳性组中，未观察到独立的 OS 负相关预测因子。
在转移性乳腺癌患者中，基于预处理容积的定量 F-FDG PET/CT 参数，特别是全身 TLG，是潜在的预后标志物。
