18F-fluorodeoxyglucose uptake as predictor for invasion in preoperatively diagnosed breast ductal carcinoma in situ: Significance in cases without mass formation
18F-fluorodeoxyglucose uptake as predictor for invasion in preoperatively diagnosed breast ductal carcinoma in situ: Significance in cases without mass formation
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18F-氟脱氧葡萄糖摄取作为术前诊断的乳腺导管原位癌侵袭的预测因子：在无肿块形成的病例中的意义
DOI：
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发表时间：
2017
影响因子：
1.2
通讯作者：
H. Kuwano
中科院分区：
文献类型：
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作者：
T. Fujii;R. Yajima;Hironori Tatsuki;H. Kuwano
导管原位癌（DCIS）在针吸活检的诊断往往会改变为浸润性导管癌，作为外科手术后的明确病理诊断。本研究旨在通过分析18F-氟脱氧葡萄糖-质子发射断层扫描（FDG-PET）结果，确定穿刺活检诊断为DCIS的病例中与浸润性疾病相关的因素。本研究回顾性研究了24例原发性乳腺癌患者的病例，这些患者术前经针吸活检诊断为DCIS。根据原发肿瘤的浸润情况将病例分为两组。24例患者中，13例（54.7%）为浸润性癌，11例（45.8%）为DCIS。分析显示，肿瘤中FDG摄取的存在是侵袭性疾病存在的唯一独立预测因素。无FDG摄取的病例显示浸润，所有这些最终被诊断为DCIS。在本研究中，所有病例，包括DCIS，结节状生长模式显示FDG摄取的肿瘤，和所有的情况下，没有FDG摄取被解释为具有弥漫性生长模式。目前的研究结果表明，FDG摄取在肿瘤中的存在可以被认为是一个预测浸润的情况下，导管原位癌的针吸活检，特别是在弥漫性生长模式的情况下。术前诊断为DCIS而无肿块形成且肿瘤内无FDG摄取的患者可避免前哨淋巴结活检。
A diagnosis of ductal carcinoma in situ (DCIS) at needle biopsy often changes to that of invasive ductal carcinoma as the definitive pathological diagnosis following the surgical procedure. The present study sought to identify the factors associated with invasive disease in cases diagnosed as DCIS on needle biopsy by analyzing 18F-fluorodeoxyglucose-proton emission tomography (FDG-PET) findings. The present study retrospectively investigated the cases of 24 consecutive patients with primary breast cancer who were preoperatively diagnosed with DCIS by needle biopsy. The cases were divided into two groups based on the presence of invasion in the primary tumor. Among the 24 patients, 13 (54.7%) patients had invasive carcinoma and 11 (45.8%) had DCIS. The analysis revealed that the presence of FDG uptake in the tumor was the only independent predictor of presence of the invasive disease. No cases without FDG uptake exhibited invasion and all of these were ultimately diagnosed as DCIS. In the present study, all cases, including DCIS, with a nodular growth pattern demonstrated FDG uptake in the tumors, and all cases without FDG uptake were interpreted as having a diffuse growth pattern. The present findings suggested that the presence of FDG uptake in the tumor can be considered a predictor for invasion in cases with DCIS by needle biopsy, particularly in cases with a diffuse growth pattern. Patients preoperatively diagnosed as DCIS without mass formation and without FDG uptake in the tumor may avoid sentinel lymph node biopsy.