18F-FDG PET-CT参数与新辅助化疗治疗乳腺癌的疗效的关系分析

Analysis of Relationship Between 18F-FDG PET-CT Parameters and Efficacy of Neoadjuvant Chemotherapy for Breast Cancer

目的探讨18氟代脱氧葡萄糖正电子发射体层显像-X线计算机断层成像(18F-FDGPET-CT)参数与新辅助化疗(NACT)治疗乳腺癌的疗效的关系。方法回顾性分析2016年1月-2018年6月间收治的72例乳腺癌患者临床资料,所有患者均行新辅助化疗,根据NACT疗效将患者分为有效组(n=37)和无效组(n=35),评估化疗前、化疗第1疗程后、第2疗程后患者病灶最大标准摄取值(SUVmax),测算化疗第1疗程后、第2疗程后SUV变化值(⊿SUVmax1、⊿S U Vm a x 2)、变化率(⊿S U Vm a x 1%、⊿SUVmax2%),靶组织/非靶组织平均放射性计数(T/NT)、T/NT变化值(⊿T/NT1、⊿T/NT2)及变化率(⊿T/NT1%、⊿T/NT2%),绘制ROC曲线评估各参数预测疗效的效能。结果①化疗第1疗程、第2疗程后,两组SUVmax均低于化疗前(P<0.05),且随时间变化而降低(P<0.05),有效组各时间点SUVmax水平均低于无效组(P<0.05);②有效组⊿SUVmax1、⊿SUVmax2、⊿SUVmax1%、⊿SUVmax2%均高于无效组(P<0.05);③有效组T/NT、⊿T/NT1、⊿T/NT2、⊿T/NT1%、⊿T/NT2%均高于无效组(P<0.05);④各指标中,SUVmax2%的AUC最高,为0.901;⊿T/NT2%的灵敏度最高,为0.914%;⊿T/NT2的特异度最高,为0.919。结论 18F-FDG PET-CTSUVmax、T/NT变化值和变化率均与NACT疗效关系密切,可早期预测乳腺癌患者NACT疗效。

Objective To explore the relationship between 18-fluorodeoxyglucose positron emission tomography-X-ray computed tomography(18F-FDG PET-CT)parameters and efficacy of neoadjuvant chemotherapy(NACT)for breast cancer.Methods The clinical data of 72 patients with breast cancer admitted from January 2016 to June 2018 were retrospectively analyzed.All patients were given neoadjuvant chemotherapy.Patients were divided into effective group(n=37)and ineffective group(n=35)according to NACT efficacy.The maximum standard uptake value(SUVmax)was evaluated before chemotherapy,after the first course of chemotherapy and after the second course of treatment.And the SUV change(⊿SUVmax1,⊿SUVmax2),change rate(⊿SUVmax1%,⊿SUVmax2%),target tissue/non-target tissue average radioactivity count(T/NT),T/NT change value(⊿T/NT1,⊿T/NT2)and change rate(⊿T/NT1%,⊿T/NT2%)were measured after the first course of chemotherapy and after the second course of chemotherapy.The ROC curve was drawn to evaluate the efficacy of each parameter for predicting efficacy.Results After the first course of chemotherapy and after the second course of chemotherapy,the SUVmax values in the two groups were lower than those before chemotherapy(P<0.05),and they were decreased with time(P<0.05),and the SUVmax level in effective group was lower than that in ineffective group at each time point(P<0.05).The⊿SUVmax1,⊿SUVmax2,⊿SUVmax1%and⊿SUVmax2%in effective group were higher than those in ineffective group(P<0.05).The T/NT,⊿T/NT1,⊿T/NT2,⊿T/NT1%and⊿T/NT2%in effective group were higher than those in ineffective group(P<0.05).Among the indicators,the AUC of SUVmax2%was the highest with 0.901.The sensitivity of⊿T/NT2%was the highest with 0.914%.The specificity of T/NT2 was the highest with 0.919.Conclusion The SUVmax,T/NT change value and change rate of 18F-FDG PET-CT are closely related to the efficacy of NACT,and they can predict the efficacy of NACT in breast cancer patients.