Quartuccio Natale, Alongi Pierpaolo, Urso Luca, Ortolan Naima, Borgia Francesca, Bartolomei Mirco, Arnone Gaspare, Evangelista Laura
Nuclear Medicine Unit, Ospedali Riuniti Villa Sofia-Cervello, 90144 Palermo, Italy.
Nuclear Medicine Unit, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, 90127 Palermo, Italy.
Cancers (Basel). 2023 May 11;15(10):2715. doi: 10.3390/cancers15102715.
We investigated whether baseline [F] Fluorodeoxyglucose (F-FDG) positron emission tomography (PET)-derived semiquantitative parameters could predict disease-free survival (DFS) in patients with grade III breast cancer (BC) of different molecular subtypes candidate to neoadjuvant chemotherapy (NAC). For each F-FDG-PET/CT scan, the following parameters were calculated in the primary tumor (SUVmax, SUVmean, MTV, TLG) and whole-body (WB_SUVmax, WB_MTV, and WB_TLG). Receiver operating characteristic (ROC) analysis was used to determine the capability to predict DFS and find the optimal threshold for each parameter. Ninety-five grade III breast cancer patients with different molecular types were retrieved from the databases of the University Hospital of Padua and the University Hospital of Ferrara (luminal A: 5; luminal B: 34; luminal B-HER2: 22; HER2-enriched: 7; triple-negative: 27). In luminal B patients, WB_MTV (AUC: 0.75; best cut-off: WB_MTV > 195.33; SS: 55.56%, SP: 100%; = 0.002) and WB_TLG (AUC: 0.73; best cut-off: WB_TLG > 1066.21; SS: 55.56%, SP: 100%; = 0.05) were the best predictors of DFS. In luminal B-HER2 patients, WB_SUVmax was the only predictor of DFS (AUC: 0.857; best cut-off: WB_SUVmax > 13.12; SS: 100%; SP: 71.43%; < 0.001). No parameter significantly affected the prediction of DFS in patients with grade III triple-negative BC. Volume-based parameters, extracted from baseline F-FDG PET, seem promising in predicting recurrence in patients with grade III luminal B and luminal B- HER2 breast cancer undergoing NAC.
我们研究了基线[F]氟脱氧葡萄糖（F-FDG）正电子发射断层扫描（PET）得出的半定量参数是否能够预测不同分子亚型的III期乳腺癌（BC）患者在接受新辅助化疗（NAC）后的无病生存期（DFS）。对于每次F-FDG-PET/CT扫描，在原发肿瘤（SUVmax、SUVmean、MTV、TLG）和全身（WB_SUVmax、WB_MTV和WB_TLG）中计算以下参数。采用受试者工作特征（ROC）分析来确定预测DFS的能力，并找到每个参数的最佳阈值。从帕多瓦大学医院和费拉拉大学医院的数据库中检索出95例不同分子类型的III期乳腺癌患者（luminal A型：5例；luminal B型：34例；luminal B-HER2型：22例；HER2富集型：7例；三阴性：27例）。在luminal B型患者中，WB_MTV（AUC：0.75；最佳截断值：WB_MTV > 195.33；灵敏度：55.56%，特异度：100%；P = 0.002）和WB_TLG（AUC：0.73；最佳截断值：WB_TLG > 1066.21；灵敏度：55.56%，特异度：100%；P = 0.05）是DFS的最佳预测指标。在luminal B-HER2型患者中，WB_SUVmax是DFS的唯一预测指标（AUC：0.857；最佳截断值：WB_SUVmax > 13.12；灵敏度：100%；特异度：71.43%；P < 0.001）。没有参数对III期三阴性乳腺癌患者的DFS预测有显著影响。从基线F-FDG PET中提取的基于体积的参数，在预测接受NAC的III期luminal B型和luminal B-HER2型乳腺癌患者的复发方面似乎很有前景。
