Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
Department of Surgery, Busan Cancer Center, Pusan National University Hospital and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
BMC Cancer. 2021 Oct 27;21(1):1151. doi: 10.1186/s12885-021-08886-2.
This study aimed to evaluate the potential of metabolic activity of the psoas muscle measured by F-fluorodeoxyglucose positron emission tomography-computed tomography to predict treatment outcomes in patients with resectable breast cancer.
The medical records of 288 patients who had undergone surgical resection for stages I-III invasive ductal carcinoma of the breast between January 2014 and December 2014 in Pusan National University Hospital were reviewed. The standardized uptake values (SUVs) of the bilateral psoas muscle were normalized using the mean SUV of the liver. SUVRmax was calculated as the ratio of the maximum SUV of the average bilateral psoas muscle to the mean SUV of the liver. SUVRmean was calculated as the ratio of the mean SUV of the bilateral psoas muscle to the mean SUV of the liver.
Univariate analyses identified a higher T stage, higher N stage, estrogen receptor negativity, progesterone receptor negativity, human epidermal growth factor receptor 2 positivity, triple-negative breast cancer, mastectomy (rather than breast-conserving surgery), SUVRmean > 0.464, and SUVRmax > 0.565 as significant adverse factors for disease-free survival (DFS). Multivariate Cox regression analysis revealed that N3 stage (hazard ratio [HR] = 5.347, P = 0.031) was an independent factor for recurrence. An SUVRmax > 0.565 (HR = 4.987, P = 0.050) seemed to have a correlation with shorter DFS.
A higher SUVRmax of the psoas muscle, which could be a surrogate marker of insulin resistance, showed strong potential as an independent prognostic factor for recurrence in patients with resectable breast cancer.
本研究旨在评估通过 F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描测量的腰大肌代谢活性预测可切除乳腺癌患者治疗结局的潜力。
回顾了 2014 年 1 月至 2014 年 12 月期间在釜山国立大学医院接受手术切除的 I-III 期浸润性导管癌的 288 例患者的病历。双侧腰大肌的标准化摄取值（SUV）通过肝脏的平均 SUV 进行归一化。SUVRmax 计算为平均双侧腰大肌的最大 SUV 与肝脏平均 SUV 的比值。SUVRmean 计算为双侧腰大肌的平均 SUV 与肝脏平均 SUV 的比值。
单因素分析发现，较高的 T 分期、较高的 N 分期、雌激素受体阴性、孕激素受体阴性、人表皮生长因子受体 2 阳性、三阴性乳腺癌、乳房切除术（而非保乳手术）、SUVRmean > 0.464 和 SUVRmax > 0.565 是无病生存（DFS）的显著不良因素。多因素 Cox 回归分析显示，N3 期（危险比[HR] = 5.347，P = 0.031）是复发的独立因素。SUVRmax > 0.565（HR = 4.987，P = 0.050）似乎与较短的 DFS 相关。
腰大肌的 SUVRmax 较高，可能是胰岛素抵抗的替代标志物，显示出作为可切除乳腺癌患者复发的独立预后因素的强大潜力。
