乳腺癌原发灶^(18)F-FDG PET-CT代谢参数与患者临床病理特征的关系研究

Relationship between ^(18)F-FDG PETCT Metabolism Parameters and Clinicopathological Features of Primary Lesions of Breast Cancer

目的探讨乳腺癌原发灶18F-脱氧葡萄糖(18F-FDG)正电子发射计算机断层扫描(PET-CT)代谢参数与患者临床病理特征的关系。方法收集2013年3月-2018年3月在我院行18F-FDGPET-CT检查并经手术病理证实的45例乳腺癌患者临床资料,测定乳腺癌原发灶最大标准摄取值(SUVmax)、代谢体积(MTV)、糖酵解总量(totallesionglycolysis,TLG)等代谢参数及转移淋巴结的SUVmax。结果45例乳腺癌均有较高18F-FDG摄取,原发灶SUVmax为(4.88±1.52),SUVmean为(2.59±0.81),MTV为(8.19±2.51)cm3,TLG为(21.96±6.42)g;其中28例有淋巴结转移,转移淋巴结SUVmax为(3.79±1.14)。乳腺癌原发灶SUVmax、MTV、TLG与均肿瘤最大径、组织学分级、T分期、淋巴结转移有明显相关性(P<0.05)。ER阴性者较ER阴性者TLG明显增高(P<0.05),PR阴性者较阳性者MTV、TLG明显增高(P<0.05)。而HER-2阳性与阴性者、p53阳性与阴性者的SUVmax、MTV、TLG比较差异均无统计学意义(P>0.05)。Spearman相关性分析显示,乳腺癌转移淋巴结的SUVmax与原发灶SUVmax、MTV、TLG均呈正相关(r=0.476、0.469、0.437,P<0.05),且与T分期亦呈正相关(r=0.613,P<0.05)。结论乳腺癌原发灶18F-FDGPET-CT代谢参数与临床病理特征具有相关性,其中以TLG最为显著。

Objective To investigate the relationship between 18 F-fluorodeoxy glucose(FDG) positron emission computed tomography(PET-CT) metabolism parameters and clinicopathological features of primary lesions of breast cancer. Methods The clinical data of45 patients with breast cancer examined by 18 F-FDG PET-CT and confirmed by surgery and pathology in the hospital from March 2013 to March 2018 werecollected. Metabolism parameters such as the maximum standardized uptake value(SUVmax), metabolic tumor volume(MTV) and total lesion glycolysis(TLG)of primary lesions of breast cancer and SUVmax of metastatic lymph nodes were determined. Results The 18 F-FDGuptake of the 45 cases was relatively higher. The SUVmax, SUVmean, MTV and TLG of primary lesions were(4.88±1.52),(2.59±0.81),(8.19±2.51)cm3 and(21.96±6.42)g respectively.There were 28 cases with lymph node metastases, and the SUVmax of metastatic lymph nodes was(3.79±1.14). The SUVmax, MTV and TLG of primary lesions of breast cancer were significantly correlated with the maximum diameter, histological grade, T stage and lymph node metastasis(P<0.05). The TLG of ER-negative patients was significantly higher than that of ER-negative patients(P<0.05). The MTV and TLG of PR-negative patients were significantly higher than those of positive patients(P<0.05). There was no significant difference in SUVmax, MTV or TLG between HER-2 positive and negative patients or between p53 positive and negative patients(P>0.05). Spearman correlation analysis showed that the SUVmax of metastatic lymph nodes in breast cancer was positively correlated with the SUVmax, MTV and TLG of primary lesions(r=0.476, 0.469, 0.437,P<0.05), and positively correlated with Tstage(r=0.613, P<0.05). Conclusion There is a correlation between 18 F-FDG PET-CT metabolism parameters and clinicopathological features of primary lesions of breast cancer, and the correlation of TLG is the most significant.