^(18)F-FDG-PET/CT对复发转移性乳腺癌疗效预测价值的临床研究

Clinical study of the early prediction value of ^(18)F-FDG-PET/CT to chemotherapy efficacy in recurrent and metastatic breast cancer

目的 18氟脱氧葡萄糖正电子发射成像/电子计算机断层扫描(18 F-FDG-PET/CT)不仅可提供肿瘤大小等解剖学信息,而且可从细胞分子水平反映人体生化和代谢变化,本研究旨在对18F-FDG-PET/CT早期预测复发转移性乳腺癌治疗缓解率的价值进行初步研究。方法选择2010-01-01-2014-12-31复发转移的乳腺癌患者18例,所有患者均于治疗前(PET/CT1)和治疗1个周期后(PET/CT2)分别显像1次。根据近期疗效分为客观缓解(OR)组(n=10)和非客观缓解(non-OR)组(n=8),分析OR组和non-OR组之间PET/CT1SUVmax、PET/CT2SUVmax、ΔSUVmax和SUVmax变化率的差异。SUVmax变化率以20.00%为界值,≥20%为代谢反应组(n=12),<20.00%为无代谢组(n=6),分析代谢反应组与无代谢反应组患者OR、DCR的差异。结果 OR组患者的ΔSUVmax为2.609±0.299,显著高于non-OR组的0.975±0.395,t=3.368,P=0.003 9;OR组SUVmax变化率为(37.250±3.102)%,明显高于non-OR组(16.300±4.111)%,t=4.148,P=0.000 8;代谢反应组缓解率为83.33%,明显优于无代谢反应组,差异均有统计学意义,χ2=13.92,P<0.001。结论 18F-FDG-PET/CT对复发转移性乳腺癌治疗缓解率具有重要的早期临床预测价值。

OBJECTIVE To explore the early prediction value of 18 F-FDG-PET / CT for chemotherapy remission rates in recurrent and metastasis of breast cancer patients. METHODS Eighteen patients diagnosed with recurrent metastatic breast cancer between Jan. 1,2010 and Dec. 31,2014 were enrolled in this study. All patients underwent PET/CT examination before （PET/CT1） and after （PET/CT2） chemotherapy. According to the objective remission, patients were divided into OR group （n = 10） and non-OR group （n=8）. According to the change rate of SUVmax, patients were divided into metabolic responsive group （n=12） and non-responsive group （n= 6）. The differences of PET/CT1 SUVmax, PET/CT2 SUVmax and the change rate of SUVmax between OR group and non-OR group, as well as the difference of OR rate and disease control rate （DCR） between the metabolic responsive group and non-responsive group were analyzed. RESULTS The ASUVmax in OR group （2. 609±0. 299） was significantly higher than that in non-OR group （0. 975 ± 0. 395）, t= 3. 368, P= 0. 003 9, and the change rate of SUVmax in OR group （37. 250 ±3. 102）% was significantly higher than that of non-OR group （16. 300 ±4. 111）%, t = 4. 148, P = 0. 000 8. The remission rate of metabolic response group was 83.33%, which was significantly higher than that of non-responder group, χ^2 =13.92, P〈0. 001. The differences were all statistically significant. CONCLUSION PET/CT has important clinical value in early prediction of chemotherapy efficacy in patients with recurrent and metastatic breast cancer.