乳腺癌18 F-FDG PET/CT显像SUV max与病理特征的相关性研究

The Correlation Between SUV max and PathologicalCharacteristics of Breast Cancer

目的分析乳腺癌18 F-FDG PET/CT显像SUV max与病理特征的相关性,研究18 F-FDG PET/CT对预测乳腺癌病理特征的价值。方法40例初诊乳腺癌患者参与回顾性分析。根据不同病理特征分组,包括病理类型、核分级、T分期、淋巴结转移、远处转移、Ki-67增殖指数、HER2表达、ER表达、PR表达及Luminal分型。独立样本t检验、ANOVA检验比较组间SUV max差异;选择与SUV max相关的病理特征行多重线性回归分析;受试者工作特征曲线分析预测Ki-67高表达的SUV max截取值。结果t检验示高T分期组(T3~T4期)SUV max高于低T分期组(T1~T2期)(t=2.089,P=0.044);Ki-67高表达(≥20%)SUV max高于低表达(<20%)(t=6.909,P<0.001);高核分级(III级)SUV max高于低核分级(I、II级)(t=8.14,P<0.001)。多重线性回归分析示Ki-67、核分级与SUV max值明显相关(P=0.017、0.001)。当SUV max截取值为5.15时,预测Ki-67高表达的诊断效能最大,灵敏度为87.5%,特异性为85.0%(曲线下面积:0.921,标准误=0.043,P<0.05)。结论乳腺癌Ki-67高表达、高核分级与高SUV max相关,18 F-FDG PET/CT对于预测乳腺癌病理特征有重要的参考价值。

Objective The aim of this study was to assess the value of the 18 F-FDG PET/CT for predicting the pathological characteristics of breast cancer by analyzing the correlation between SUV max and pathological characteristics,including pathological type,nuclear grade,T stage,lymph node metastasis,distant metastasis,Ki-67 proliferation index,HER2 expression,ER expression,PR expression and luminal subtype.Methods 40 patients with newly diagnosed breast cancer were enrolled for the study.All patients underwent preoperative 18 F-FDG PET/CT,and the results were compared with pathological characteristics by an independent sample t-test and analysis of variance.The characteristics that were correlated with SUV max were analyzed by a multi-linearity regression analysis.Cut-off value of SUV max was analyzed by the receiver-operating characteristic curve.Results SUV max level was significantly correlated with T stage(P=0.044),Ki-67 index(P<0.001)and nuclear grade(P<0.001).Multivariate analysis showed that Ki-67 overexpression and high nuclear grade(P=0.017,P=0.001)were significantly correlated with the high level of SUV max in breast cancer.The receiver-operating characteristic curve demonstrated a SUV max of 5.15 to be the optimal cut-off for predicting Ki-67 overexpression(sensitivity:87.5%;specificity:85.0%).Conclusion Ki-67 overexpression and high nuclear grade are significantly correlated with the high level of SUV max in breast cancer.18 F-FDG PET/CT could be a useful tool to predict the pathological characteristics of breast cancer.