Comparison of triple-negative and estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast carcinoma using quantitative fluorine-18 fluorodeoxyglucose/positron emission tomography imaging parameters
Comparison of triple-negative and estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast carcinoma using quantitative fluorine-18 fluorodeoxyglucose/positron emission tomography imaging parameters
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DOI：
10.1002/cncr.23226
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发表时间：
2008-03-01
期刊：
影响因子：
6.2
通讯作者：
Alavi, Abass
中科院分区：
文献类型：
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作者：
Basu, Sandip;Chen, Wengen;Alavi, Abass
背景本研究旨在探讨三阴性（雌激素受体阴性[ER-]/孕激素受体阴性[PR-]/HER 2阴性[HER 2-]）乳腺癌的氟-18-脱氧葡萄糖（FDG）正电子发射断层扫描（PET）成像特征，并与ER+/PR+/HER 2-乳腺癌的特征进行比较，后者通常具有良好的生物学行为。在任何治疗干预前接受双时间点FDG-PET检查并在手术标本的组织病理学检查中确定为ER-/PR-/HER 2-或ER+/PR+/HER 2-（对照组）的新诊断乳腺癌患者被视为纳入本分析的候选人。这些患者接受了FDG-PET作为前瞻性研究的一部分，该研究评价了多模态成像在表征原发性乳腺病变和局部区域分期中的作用。在给予FDG后约63分钟和101分钟对乳腺癌病变进行两次成像。在两个时间点（SUVmax 1和SUVmax 2）测量最大标准化摄取值（SUVmax），以分析生成的数据。FDG-PET成像后，患者接受保乳手术或乳房切除术，组织病理学报告用于提供明确的诊断，并与PET研究结果进行比较。在入组研究方案的206名个体中，共选择了88名乳腺癌患者（29名“三阴性”乳腺癌患者和59名ER+/PR+/HER 2-乳腺恶性肿瘤患者）。“三阴性”组占总研究人群的14.08%。该亚型肿瘤患者的年龄范围为33岁至75岁（平均年龄标准差为51.6 ± 10.1岁），该亚组中的肿瘤大小范围为0.9 cm至6 cm（平均大小为1.99 cm）。在组织病理学亚型中，25例为浸润性导管癌（86%），小叶型、混合型导管-小叶型、髓样型和管状型各1例（各占3.5%）。对于该组中FDG-PET参数的计算，仅考虑了在任何干预之前接受FDG-PET研究的患者，三阴性组中有18例患者符合该标准。根据相同的标准，选择59例具有局灶性FDG摄取的ER+/PR+/HER 2-癌症患者作为对照组，与三阴性人群进行比较。在三阴性组中，所有患者的乳腺癌病灶均观察到FDG摄取局灶性增强（灵敏度为100%）。三阴性组原发性病变的平均（标准差）SUVmax 1为7.27 +/- 5.6，平均SUVmax 2为8.29 +/- 6.4，SUVmax的百分比变化（%Delta SUVmax）为14.3 +/-15.8%。在59例ER+/PR+/HER 2-乳腺癌患者的对照组中，SUVmax 1、SLTVmax 2和%Delta SUVmax的平均值分别为2.68 +/- 1.9、2.84 +/- 2.2和3.7 +/-13.0%。三阴性组的SUVmax 1、SUVmax 2和%Dgr;SUVmax的平均值显著高于非三阴性对照组（分别为P = 0.0032、P = 0.002和P = 0.017）。当根据肿瘤大小、分级和分期对两个亚组进行比较时，三阴性组的SUVmax 1在两种大小类别（5.4 vs 1.9，P = 0.006;和9.2 vs 3.5，P = 0.04）和3级肿瘤（9.1 vs 3.9，P = 0.022）中显著更高。三阴性组中肿瘤测量值2 cm的患者的%Delta SUVmax值分别为14.8和13.8;对照组中患者的相应值分别为0.6和6.7。尽管对于两种肿瘤大小类别，三阴性组的平均% Δ SUVmax明显较高，但两组之间的比较表明，测量的肿瘤
BACKGROUND. This study was designed to investigate the fluorine-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET) imaging characteristics of triple-negative (estrogen receptor-negative [ER-]/progesterone receptor-negative [PR-]/HER2-negative [HER2-]) breast carcinoma and compare the results with characteristics of ER+/PR+/HER2- breast carcinomas, which usually carry a favorable prognosis.METHODS. Patients with newly diagnosed breast carcinoma who had undergone dual-time-point FDG-PET before any therapeutic intervention and were identified as either ER-/PR-/HER2- or ER+/PR+/HER2- (the control group) on histopathology of the surgical specimen, were considered candidates for inclusion in this analysis. These patients underwent FDG-PET as a component of a prospective study that evaluated the role of multimodality imaging for characterizing primary breast lesions and locoregional staging. Breast cancer lesions were imaged twice at approximately 63 minutes and 101 minutes after the administration of FDG. Maximum standardized uptake values (SUVmax) were measured at both time points (SUVmax1 and SUVmax2) to analyze the data generated. After FDG-PET imaging, the patients underwent either breast-conserving surgery or mastectomy, and histopathology reports were used to provide the definitive diagnosis against which the PET study results were compared.RESULTS. In total, 88 patients with breast cancer (29 patients with 'triple-negative' breast cancer and 59 patients with ER+/PR+/HER2- breast malignancies) were selected among 206 individuals who were enrolled in the study protocol. The 'triple-negative' group comprised 14.08% of the total study population. The age of the patients with this subtype of tumor ranged from 33 years to 75 years (mean age standard deviation, 51.6 +/- 10.1 years), and tumors in this subgroup ranged in size from 0.9 cm to 6 cm (mean size, 1.99 cm). Among the histopathologic subtypes, 25 tumors were infiltrating ductal carcinoma (86%), and 1 tumor each (3.5% each subtype) was lobular, mixed ductal-lobular, medullary, and tubular. For the calculation of FDG-PET parameters in this group, only patients who had undergone FDG-PET studies before any intervention were considered, and 18 patients in the triple-negative group met this criterion. According to same criterion, a control group of 59 patients with ER+/PR+/HER2- cancer who had focal FDG uptake were selected for comparison with the triple-negative population. The breast cancer lesions were observed as areas with focally enhanced uptake of FDG in all patients (sensitivity, 100%) in the triple-negative group. The mean ( standard deviation) SUVmax1 of the primary lesion for the triple-negative group was 7.27 +/- 5.6, the mean SUVmax2 was 8.29 +/- 6.4, and the percentage change in SUVmax (%Delta SUVmax) was 14.3 +/- 15.8%. In the control group of 59 patients with ER+/PR+/HER2- breast carcinoma, the mean values for SUVmax1, SLTVmax2, and %Delta SUVmax were 2.68 +/- 1.9, 2.84 +/- 2.2, and 3.7 +/- 13.0%, respectively. The mean values for SUVmax1, SUVmax2, and %Dgr;SUVmax in the triple-negative group were significantly higher compared with the values in the nontriple-negative control group (P = .0032, P = .002, and P = .017, respectively). When the 2 subgroups were compared according to tumor size, grade, and stage, the SUVmax1 was significantly higher in the triple-negative group for both size categories (5.4 vs 1.9, P = .006; and 9.2 vs 3.5, P = .04) and for grade 3 tumors (9.1 vs 3.9, P = .022). The %Delta SUVmax values for patients in the triple-negative group who had tumors that measured 2 cm were 14.8 and 13.8, respectively; and the corresponding values for patients in the control group were 0.6 and 6.7, respectively. Although the mean %Delta SUVmax clearly was higher in the triple-negative group for both tumor size categories, comparison between the 2 groups demonstrated a statistically significant difference in tumors that measured