乳腺浸润性导管癌^(18)F-FDG摄取的影响因素分析

Analysis of the factors affecting ^(18)F-FDG uptake in infiltrating ductal carcinoma of breast

目的:探讨肿瘤大小、病理分级、有无淋巴结转移及病理分子标志物雌激素受体(ER)、孕激素受体(PR)、表皮生长因子受体(C-erbB-2)、p53抑癌基因(p53)及增殖细胞核抗原Ki67(Ki67)对乳腺浸润性导管癌18F-FDG摄取的影响。方法:37例病理证实乳腺浸润性导管癌术前18F-FDG PET/CT SUVmax与术后病理免疫组化结果进行综合分析,采用Mann-Whitney U检验进行统计学分析。结果:病灶直径≥2.5cm、肿瘤高分化(III级)、淋巴结转移组平均SUVmax分别高于<2.5cm、低分化(I-II级)及淋巴结未转移有统计学意义(P<0.05)。ER(﹣)组18F-FDG摄取程度高于ER(﹢)组(P<0.05),Ki67(﹢)组18F-FDG摄取程度高于Ki67(﹣)组,差异均有统计学意义(P<0.05)。而PR、C-erbB-2及p53对18F-FDG摄取影响不明显。结论:乳腺浸润性导管癌病灶大小、病理分级、有无淋巴结转移、ER、Ki67的表达影响18F-FDG摄取,18F-FDG PET/CT鉴别诊断及初步分期时应引起重视。

Objective：To determine the impact of size of foci,tumor grade,lymph node status,and estrogen receptor（ER）,progesterone receptor（PR）,pro-oncogene-C-erbB-2,p53 and Ki67 status of infiltrating ductal carcinoma of breast on 18F-fluorodeoxyglucose（FDG） uptake.Methods： All 37 consecutive women proved with ductal carcinoma received FDG PET/CT imaging and postsurgery immunohistochemistry.Results： Several biological features of poor prognostic factors were associated with increase in FDG uptake： size≥2.5cm,higher grade（III）,lymph metastasis tumors had significantly higher SUVmax（P〈0.05）;ER（-） and Ki67（＋） also had significantly higher SUVmax than ER（-） and Ki67（-）（P〈0.05）.However,there was no influence of PR,C-erbB-2,p53 on SUVmax.Conclusion： Size tumor grade,lymph node status,ER,and Ki67 status of infiltrating ductal carcinoma of breast affects 18F-FDG uptake,these prognostic factors should be taken into account for differentiation and baseline staging with 18F-FDG PET/CT.