18F-FDG PET/CT SUVmax与乳腺浸润性导管癌临床病理特征及新辅助化疗疗效的相关性

目的探讨18F-脱氧葡萄糖(FDG)正电子发射计算机断层扫描(PET/CT)显像治疗前病灶最大标准摄取值(maximum standard uptake value, SUV_max)与乳腺浸润性导管癌临床病理特征的关系及与新辅助化疗疗效的相关性,以指导临床个体化治疗。方法选取佛山市第一人民医院行¹⁸F-FDG PET/CT显像的272例初治乳腺浸润性导管癌患者的临床资料进行回顾性分析,测定原发病灶的SUV_max,分析临床病理特征、分子分型及新辅助化疗疗效与原发灶SUV_max的相关性。结果乳腺癌原发灶的SUV_max在不同T分期、不同组织学分级、有无淋巴结转移方面差异均有统计学意义(P<0.05),雌激素受体(ER)和(或)孕激素受体(PR)阳性组与阴性组的SUV_max差异有统计学意义(P<0.05),人表皮生长因子受体2(HER2)阳性组与阴性组的SUV_max差异无统计学意义(P>0.05),Ki-67高表达者SUV_max高于低表达者(P<0.05)。Basal-like型和HER2过表达型SUV_max均高于Luminal A型乳腺癌(P<0.05)。病理完全缓解组与未达到病理缓解组SUV_max差异有统计学意义(P<0.05)。结论 ¹⁸F-FDG PET/CT SUV_max与乳腺癌的临床病理特征具有较大的相关性,原发病灶SUV_max较高者更能从新辅助化疗中获益。

Correlation Between 18F-FDG PET/CT SUVmax and Clinicopathological Features,Neoadjuvant Chemotherapy Response in Invasive Ductal Breast Carcinoma Patients

Objective To investigate the relationship between 18F-fluorodeoxy glucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) maximum standard uptake value (SUV_max) and clinicopathological features, neoadjuvant chemotherapy response in patients with invasive ductal breast carcinoma. Methods We retrospectively reviewed the medical records of 272 breast cancer patients who underwent ¹⁸F-FDG PET/CT in our hospital. SUV_max of primary lesions were measured. The relationship of primary lesion SUV_max with the clinicopathological features, molecular subtype and neoadjuvant chemotherapy response was analyzed. Results There were statistically significant differences of primary lesion SUV_max in different T stages, pathological stage, with or without lymph node invasion (all P<0.05). SUVmax of estrogen receptor (ER) and progesterone receptor (PR) negative patients were higher than that of ER and(or)PR positive patients (P<0.05). No significant difference of SUVmax was found between human epidermal growth factor receptor 2（HER-2）negative and positive patients(P>0.05). SUV_max of primary lesion were higher in patients with Ki-67≥14% than that with Ki-67<14%(P<0.05). SUV_max in Basal-like and HER2 overexpression groups were higher than that in Luminal A group(P<0.05). SUV_max in pathologic complete response (pCR) group was higher than that in no pCR group(P<0.05). Conclusion ¹⁸F-FDG PET/CT SUV_max is correlated with clinicopathological feature of breast cancer patients. Patients with higher SUV_max of primary lesion could benefit better from neoadjuvant chemotherapy.