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18F-FDG PET/CT在复发转移性乳腺癌中的临床价值
         
Clinical value of 18F-FDG-PET/CT in recurrent and metastatic breast cancer

摘    要
目的:探讨18F-脱氧葡萄糖(fluorodeoxyglucose,FDG)PET/CT应用于复发转移性乳腺癌的临床意义。 方法:选择2010年1月1日—2017年12月31日病理学诊断为乳腺浸润性导管癌患者45例,按孕激素受体(progesterone receptor,PR)、雌激素受体(estrogen receptor,ER)、人类表皮生长因子受体2(human epidermal growth factor receptor-2,HER-2)和Ki-67的表达状态分为Luminal A型、Luminal B型、HER-2过表达型和Basal-like型。对所有患者均进行18F-FDG PET/CT检查,分析18F-FDG PET/CT最大葡萄糖标准摄取值(the maximum standard uptake value of glucose,SUVmax)与乳腺癌不同ER、PR、HER-2状态、分子分型和肿瘤分级间的关系。其中18例患者于化疗后再次进行18F-FDG PET/CT检查,以SUVmax变化率=20%为界值将患者分为代谢反应组(SUVmax变化率≥20%,12例)和代谢无反应组(SUVmax变化率<20%,6例),分析2组患者与总生存期之间的关系。 结果:ER阴性组(19例)、PR阴性组(27例)和HER-2阳性组(7例)患者的SUVmax分别高于相应的ER阳性组(26例)、PR阳性组(18例)和HER-2阴性组(38例),差异均有统计学意义(P值均<0.05)。Basal-like型和HER-2过表达型乳腺癌患者18F-FDG PET/CT SUVmax分别高于Luminal A型组(P<0.001,P=0.010),Basal-like型乳腺癌患者18F-FDG PET/CT SUVmax高于Luminal B型(P=0.011)。G3级乳腺癌患者18F-FDG PET/CT SUVmax分别高于G2和G1级乳腺癌患者(P值均<0.05)。代谢反应组乳腺癌患者的中位生存期长于代谢无反应组患者(P=0.001)。 结论:不同ER、PR、HER-2状态、肿瘤分级和分子分型对18F-FDG PET/CT SUVmax均有影响,18F-FDG PET/CT SUVmax与复发转移性乳腺癌患者的总生存期有关。
标    签 乳腺肿瘤   复发   肿瘤转移   肿瘤分级   Breast neoplasms   Recurrence   Neoplasm metastasis   Neoplasm grading  
 
Abstract
Objective: To explore the clinical significance of 18F-fluorodeoxyglucose (FDG) PET/CT for the treatment of recurrent and metastatic breast cancer. Methods: From January 1, 2010 to December 31, 2017, all of 45 patients with breast invasive ductal carcinoma were selected by pathological diagnosis. According to the results of progesterone receptors (PR), estrogen receptor (ER), human epidermal growth factor receptor-2 (HER-2) and Ki-67, all patients were divided into Luminal A, Luminal B, HER-2 over expression and Basal-like types. All patients underwent 18F-FDG PET/CT, then the correlations of the maximum standard uptake value (SUVmax) of glucose with the different ER, PR, HER-2 status, molecular subtype and tumor grade of breast cancer were analyzed. Of 18 patients underwent 18F-FDG PET/CT again after chemotherapy, and these patients were divided into metabolic reaction group (SUVmax change rate ≥20%, n = 12) and no metabolic response group (SUVmax change rate < 20%, n = 6), then the overall survival time of the two groups of patients was analyzed. Results: The 18F-FDG PET/CT SUVmax in ER negative group (n = 19), PR negative group (n = 27) or HER-2 positive group (n = 7) was higher than that in corresponding ER positive group (n = 26), PR positive group (n = 18) or HER-2 negative group (n = 38) (all P < 0.05), respectively. The 18F-FDG PET/CT SUVmax in Basal-like and HER-2 over expressed groups were higher than that in Luminal A group (P < 0.001, P = 0.010). The 18F-FDG PET/CT SUVmax in Basal-like group was higher than that in Luminal B group (P = 0.011). The 18F-FDG PET/CT SUVmax in G3 group was higher than those in G2 and G1 groups (both P < 0.05). The median survival time of patients with breast cancer in metabolic reaction group was longer than that in no metabolic response group (P = 0.001). Conclusion: Different ER, PR, HER-2 status, tumor grading, and molecular typing all affect 18F-FDG PET/CT SUVmax. 18F-FDG PET/CT SUVmax is correlated with the overall survival time of patients with recurrent metastatic breast cancer.

中图分类号 R737.9   DOI 10.3781/j.issn.1000-7431.2018.44.096

 
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所属栏目 临床经验

基金项目 苏州市科技计划项目(编号:SYS201404;SS201508)

收稿日期 2018/2/1

修改稿日期 2018/4/17

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引用该论文: ZHANG Yueming,ZHOU Yeming,XU Haiyan,XU Yinchun,ZHANG Fengchun. Clinical value of 18F-FDG-PET/CT in recurrent and metastatic breast cancer[J]. Tumor, 2018, 38(7): 704~710
张月明,周晔明,徐海燕,徐迎春,张凤春. 18F-FDG PET/CT在复发转移性乳腺癌中的临床价值[J]. 肿瘤, 2018, 38(7): 704~710


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