乳腺癌^(18)F-脱氧葡萄糖PET-CT标准化摄取值与Ki-67表达的关系及意义

Relationship between Standardized Uptake Value of ^(18)F-FDG PET/CT and Ki-67 Expression in Breast Cancer

目的探讨乳腺癌病灶的18F-脱氧葡萄糖(FDG)PET-CT的标准化摄取值(SUV)与Ki-67表达之间的关系及意义。方法回顾性分析经PET-CT检查的35例女性乳腺癌患者(均经病理证实)的资料,并计算病灶最大标准摄取值(SUVmax)及最大肿瘤本底比值(TBRmax);所有病例均进行Ki-67检测。结果 35例乳腺癌患者中,Ki-67高表达率达74.3%(26/35)。Ki-67阳性组与阴性组间病灶SUVmax、TBRmax差异有统计学意义(P<0.05)。Ki-67与病灶SUVmax及TBRmax呈弱正相关(r=0.410,P=0.014;r=0.571,P=0.000)。通过受试者工作特征曲线(ROC曲线)判断发现,SUVmax、TBRmax对Ki-67高表达诊断效能ROC曲线下面积分别为0.855(P=0.002)、0.906(P=0.000);乳腺癌病灶SUVmax及TBRmax最佳临界值分别为9.042、13.485(敏感性分别为0.615、0.692,特异性均为1.000)。结论乳腺癌病灶TBRmax较SUVmax能更好地间接反映Ki-67表达情况,在疗效观察及预后判断中有一定的临床应用价值。

Objective To investigate the relationship between standardized uptake value（SUV） of 18F-FDG PET/CT and Ki-67 expression in breast cancer.Methods Data from 35 patients with pathologically confirmed breast cancer who underwent PET/CT were retrospectively analyzed and maximum SUV（SUVmax） and maximum tumour to background ratio（TBRmax） were calculated.The expression of Ki-67 was detected by immunohistochemistry.Results Among the 35 patients,Ki-67 was highly expressed in 26（74.3%）.There were significant differences in SUVmax and TBRmax between Ki-67 positive patients and Ki-67 negative patients（P0.05）.The expression of Ki-67 was weakly positively correlated with SUVmax（r=0.410,P=0.014） and TBRmax（r=0.571,P=0.000）,respectively.The area under the receiver operating characteristic（ROC） curve was 0.855 for SUVmax（P=0.002） and 0.906 for TBRmax（P=0.000）.The best critical value was 9.042 for SUVmax（sensitivity,0.615;specificity,1.000） and 13.485 for TBRmax（sensitivity,0.692;specificity,1.000）.Conclusion The TBRmax is superior to SUVmax for indirectly reflecting Ki-67 expression in breast cancer and can be used to evaluate curative effect and judge prognosis.