Biological characterisation of breast cancer by means of PET
Biological characterisation of breast cancer by means of PET
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DOI：
10.1007/s00259-004-1529-6
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发表时间：
2004-06-01
影响因子：
9.1
通讯作者：
Reske, SN
中科院分区：
文献类型：
--
作者：
Buck, AK;Schirrmeister, H;Reske, SN
乳腺癌与葡萄糖消耗增加有关，因此可以通过葡萄糖类似物[F-18]2-脱氧-2-氟-D-葡萄糖(FDG)和正电子发射断层扫描(PET)进行可视化。FDG在原发肿瘤中的摄取可以有很大的不同，并且特定的肿瘤特征已经被证明决定了葡萄糖代谢的程度。影响乳腺癌摄取FDG的主要因素包括葡萄糖转运体GLUT-1和己糖激酶I的表达、单位体积活瘤细胞数、组织学亚型、肿瘤分级、微血管密度和增殖活性。最近，高摄取FDG与更差的预后之间的关联被提出。已经进行了几项研究，将FDG摄取与各种预后和分子生物标记物以及预测肿瘤治疗反应的参数相关联。但与腋窝淋巴结状态、原发灶大小、雌孕激素受体表达、原癌基因c-erbB-2、血管内皮生长因子等临床预后指标的相关性尚不明显。缺乏与重要预后标记物的相关性并不表明FDG摄取可作为乳腺癌的预后标准。与FDG PET相比，用于肿瘤灌注([O-15]H2O)、激素受体表达([F-18]FES)、蛋白质合成([C-11]蛋氨酸)、增殖率([F-18]Flt)或骨矿化([F-18]氟化物)的特定成像的创新放射性示踪剂可能提供额外的信息。
Breast cancer is associated with increased glucose consumption and can therefore be visualised with the glucose analogue [F-18]2-deoxy-2-fluoro-D-glucose (FDG) and positron emission tomography (PET). FDG uptake in the primary tumour can vary substantially, and specific tumour characteristics have been demonstrated to determine the degree of glucose metabolism. Factors with a major influence on FDG uptake in breast cancer comprise expression of glucose transporter Glut-1 and hexokinase I, number of viable tumour cells per volume, histological subtype, tumour grading, microvessel density and proliferative activity. Recently, an association between high FDG uptake and a worse prognosis was suggested. Several studies have been performed correlating FDG uptake with a variety of prognostic and molecular biomarkers as well as parameters predicting tumour response to therapy. However, a correlation with important clinical prognostic markers such as axillary lymph node status and size of the primary tumour, expression of oestrogen and progesterone receptors, proto-oncogene c-erbB-2 or VEGF could not be demonstrated. The lack of correlation with important markers of prognosis does not suggest that FDG uptake might be used as a prognostic criterion in breast cancer. Innovative radiotracers for specific imaging of tumoural perfusion ([O-15]H2O), hormone receptor expression ([F-18]FES), protein synthesis ([C-11]methionine), proliferation rate ([F-18]FLT) or bone mineralisation ([F-18]fluoride) may provide additional information compared with that provided by FDG PET.