Prognostic value of metabolic response in breast cancer patients receiving neoadjuvant chemotherapy.
Prognostic value of metabolic response in breast cancer patients receiving neoadjuvant chemotherapy.
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DOI：
10.1186/1471-2407-12-39
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发表时间：
2012-01-25
期刊：
影响因子：
3.8
通讯作者：
Gribbestad IS
中科院分区：
文献类型：
--
作者：
Cao MD;Giskeødegård GF;Bathen TF;Sitter B;Bofin A;Lønning PE;Lundgren S;Gribbestad IS
今天的临床诊断工具不足以为乳腺癌患者提供准确的预后。本研究的目的是检测新辅助化疗（NAC）引起的局部晚期乳腺癌患者的肿瘤代谢变化，并将这些变化与临床治疗反应和长期生存率联系起来。参与一项随机开放标签多中心研究的患者（n = 89）被分配接受NAC作为表阿霉素或紫杉醇单药治疗。在治疗前和治疗后切除活检组织，并通过高分辨率魔角旋转磁共振波谱（HR MAS MRS）进行分析。通过配对和非配对多变量方法检查代谢产物谱，并通过代谢产物峰的光谱积分确认重要代谢产物的结果。所有患者均对NAC有显著的代谢反应，通过配对/非配对偏最小二乘判别分析（PLS-DA），治疗前和治疗后的光谱可以以87.9%/68.9%的分类准确度进行区分（p < 0.001）。两种化疗药物的代谢反应相似。代谢反应与患者结局相关。治疗后，非存活者（< 5岁）的肿瘤乳酸水平升高（p = 0.004），而存活者（≥ 5岁）的甘氨酸（p = 0.047）和含胆碱化合物（p ≤ 0.013）水平降低，葡萄糖（p = 0.002）水平升高。代谢反应与临床治疗反应无关。肿瘤对NAC代谢反应的差异与乳腺癌生存率相关，但与临床反应无关。通过HR MAS MRS监测对NAC的代谢反应可以提供与个体预后相关的肿瘤生物学信息。
Today's clinical diagnostic tools are insufficient for giving accurate prognosis to breast cancer patients. The aim of our study was to examine the tumor metabolic changes in patients with locally advanced breast cancer caused by neoadjuvant chemotherapy (NAC), relating these changes to clinical treatment response and long-term survival. Patients (n = 89) participating in a randomized open-label multicenter study were allocated to receive either NAC as epirubicin or paclitaxel monotherapy. Biopsies were excised pre- and post-treatment, and analyzed by high resolution magic angle spinning magnetic resonance spectroscopy (HR MAS MRS). The metabolite profiles were examined by paired and unpaired multivariate methods and findings of important metabolites were confirmed by spectral integration of the metabolite peaks. All patients had a significant metabolic response to NAC, and pre- and post-treatment spectra could be discriminated with 87.9%/68.9% classification accuracy by paired/unpaired partial least squares discriminant analysis (PLS-DA) (p < 0.001). Similar metabolic responses were observed for the two chemotherapeutic agents. The metabolic responses were related to patient outcome. Non-survivors (< 5 years) had increased tumor levels of lactate (p = 0.004) after treatment, while survivors (≥ 5 years) experienced a decrease in the levels of glycine (p = 0.047) and choline-containing compounds (p ≤ 0.013) and an increase in glucose (p = 0.002) levels. The metabolic responses were not related to clinical treatment response. The differences in tumor metabolic response to NAC were associated with breast cancer survival, but not to clinical response. Monitoring metabolic responses to NAC by HR MAS MRS may provide information about tumor biology related to individual prognosis.
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DOI：
10.1016/s0360-3016(01)01630-3
发表时间：
2001-10-01
影响因子：
7
作者：
Brizel, DM;Schroeder, T;Mueller-Klieser, W
通讯作者：
Mueller-Klieser, W
影响因子：
2.9
作者：
Chen, J. -H.;Mehta, R. S.;Baek, H. -M.;Nie, K.;Liu, H.;Lin, M. Q.;Yu, H. J.;Nalcioglu, O.;Su, M. -Y.
通讯作者：
Su, M. -Y.
影响因子：
2.9
作者：
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通讯作者：
Gribbestad, Ingrid S.
影响因子：
11.2
作者：
Glunde, Kristine;Shah, Tariq;Bhujwalla, Zaver M.
通讯作者：
Bhujwalla, Zaver M.
影响因子：
2.5
作者：
Baek, Hyeon-Man;Yu, Hon J.;Su, Min-Ying
通讯作者：
Su, Min-Ying