乳腺癌新辅助化疗过程中18F-FDGPET-CT与化疗前Ki-67、COX-2表达的相关性研究

The correlation analysis between 18F-FDG PET-CT in breast cancer with neoadjuvant chemotherapy and the expression of Ki-67 and COX-2 before neoadjuvant chemotherapy

目的研究乳腺癌新辅助化疗过程中mF—FDGPET—CT的病灶最大标准化摄取值（SUVmax）的变化与其化疗前Ki-67（一种增殖细胞核抗原）、环氧合酶2（COX-）表达的相关性。方法初治乳腺癌患者19例，在新辅助化疗前、第1疗程结束后及第2疗程结束后分别行18F—FDGPET—CT，并计算病灶的SUVmax变化率，在新辅助化疗前取患者乳腺肿瘤组织标本进行Ki-67、COX-2免疫组化检查，并比较不同Ki-67和COX-2表达组之间的suvmax变化率。结果新辅助化疗前、第1疗程及第2疗程结束后的SUVmax变化率在化疗前Ki-67、COX-2不同表达组之间差异均无统计学意义。结论化疗前Ki-67、COX-2的表达情况无法充分解释病灶在新辅助化疗过程中18F-FDG的摄取变化，而其最有可能的解释是细胞之间复杂的能源需求与肿瘤微环境的相互作用。

Objective To study the expression of Ki-67 （a kind of proliferation cell nuclear antigen）, cyclooxygenase-2 （COX-2） in breast cancer befbre neoadjuvant chemotherapy, and its correlation with the changes of maximum standarded uptake value （SUV）. Methods In a prospertive trial, ISF-FDG PET-CT were performed in 19 women with primary breast cancer before and after the first and second cycle of neoadjuvant chemotherapy respectively, the changes of SUVmax were computered. Divided the patients into ditterent groups according to the Ki-67 and COX-2 expression, then compared the rate of change of SUVmax in different groups. Results There was no correlation between the changes of SUVmax, after chemotherapy and the expression of Ki-67, COX-2 before neoadjuvant chemotherapy. Conclusions The expression of Ki-67 and COX-2 before neoadjuvant chemotherapy were unable to sufficiently explain the changes of 18F-FDG uptake during the chemotherapy process. The metabolic changes were most likely explained by a complex interaction between cellular energy demand and tumoral microenvironment.