受体表达和临床亚型对乳腺癌基线[18F]FDG摄取的影响：系统评价和荟萃分析。

The influence of receptor expression and clinical subtypes on baseline [18F]FDG uptake in breast cancer: systematic review and meta-analysis.

作者信息

de Mooij Cornelis M, Ploumen Roxanne A W, Nelemans Patty J, Mottaghy Felix M, Smidt Marjolein L, van Nijnatten Thiemo J A

机构信息

Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.

Department of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands.

出版信息

EJNMMI Res. 2023 Jan 23;13(1):5. doi: 10.1186/s13550-023-00953-y.

DOI:10.1186/s13550-023-00953-y

PMID:36689007

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9871105/

Abstract

BACKGROUND

To quantify the relationship between [18F]FDG uptake of the primary tumour measured by PET-imaging with immunohistochemical (IHC) expression of ER, PR, HER2, Ki-67, and clinical subtypes based on these markers in breast cancer patients.

METHODS

PubMed and Embase were searched for studies that compared SUV between breast cancer patients negative and positive for IHC expression of ER, PR, HER2, Ki-67, and clinical subtypes based on these markers. Two reviewers independently screened the studies and extracted the data. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were estimated by using DerSimonian-Laird random-effects models. P values less than or equal to 5% indicated statistically significant results.

RESULTS

Fifty studies were included in the final analysis. SUV is significantly higher in ER-negative (31 studies, SMD 0.66, 0.56-0.77, P < 0.0001), PR-negative (30 studies, SMD 0.56; 0.40-0.71, P < 0.0001), HER2-positive (32 studies, SMD - 0.29, - 0.49 to - 0.10, P = 0.0043) or Ki-67-positive (19 studies, SMD - 0.77; - 0.93 to - 0.61, P < 0.0001) primary tumours compared to their counterparts. The majority of clinical subtypes were either luminal A (LA), luminal B (LB), HER2-positive or triple negative breast cancer (TNBC). LA is associated with significantly lower SUV compared to LB (11 studies, SMD - 0.49, - 0.68 to - 0.31, P = 0.0001), HER2-positive (15 studies, SMD - 0.91, - 1.21 to - 0.61, P < 0.0001) and TNBC (17 studies, SMD - 1.21, - 1.57 to - 0.85, P < 0.0001); and LB showed significantly lower uptake compared to TNBC (10 studies, SMD - 0.77, - 1.05 to - 0.49, P = 0.0002). Differences in SUV between LB and HER2-positive (9 studies, SMD - 0.32, - 0.88 to 0.24, P = 0.2244), and HER2-positive and TNBC (17 studies, SMD - 0.29, - 0.61 to 0.02, P = 0.0667) are not significant.

CONCLUSION

Primary tumour SUV is significantly higher in ER-negative, PR-negative, HER2-positive and Ki-67-positive breast cancer patients. Luminal tumours have the lowest and TNBC tumours the highest SUV. HER2 overexpression has an intermediate effect.

摘要

背景

通过正电子发射断层扫描（PET）成像测量原发性肿瘤的[18F]氟代脱氧葡萄糖（FDG）摄取，与乳腺癌患者雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER2）、Ki-67的免疫组化（IHC）表达以及基于这些标志物的临床亚型之间的关系进行量化。

方法

检索PubMed和Embase，查找比较ER、PR、HER2、Ki-67免疫组化表达阴性和阳性的乳腺癌患者以及基于这些标志物的临床亚型之间的标准化摄取值（SUV）的研究。两名评审员独立筛选研究并提取数据。使用DerSimonian-Laird随机效应模型估计标准化平均差异（SMD）和95%置信区间（CI）。P值小于或等于5%表示具有统计学意义的结果。

结果

最终分析纳入了50项研究。与ER阴性（31项研究，SMD 0.66，0.56 - 0.77，P < 0.0001）、PR阴性（30项研究，SMD 0.56；0.40 - 0.71，P < 0.0001）、HER2阳性（32项研究，SMD - 0.29， - 0.49至 - 0.10，P = 0.0043）或Ki-67阳性（19项研究，SMD - 0.77； - 0.93至 - 0.61，P < 0.0001）的原发性肿瘤相比，其对应肿瘤的SUV显著更高。大多数临床亚型为腔面A型（LA）、腔面B型（LB）、HER2阳性或三阴性乳腺癌（TNBC）。与LB（11项研究，SMD - 0.49， - 0.68至 - 0.31，P = 0.0001）、HER2阳性（15项研究，SMD - 0.91， - 1.21至 - 0.61，P < 0.0001）和TNBC（17项研究，SMD - 1.21， - 1.57至 - 0.85，P < 0.0001）相比，LA的SUV显著更低；与TNBC相比，LB的摄取显著更低（10项研究，SMD - 0.77， - 1.05至 - 0.49，P = 0.0002）。LB与HER2阳性之间（9项研究，SMD - 0.32， - 0.88至0.24，P = 0.2244）以及HER2阳性与TNBC之间（17项研究，SMD - 0.29， - 0.61至0.02，P = 0.0667）的SUV差异不显著。