摘要
目的分析乳腺癌表皮生长因子受体(EGFR)表达与^(18)F-FDG PET/CT代谢参数间的相关性,并评价^(18)F-FDG PET/CT代谢参数对乳腺癌EGFR阳性表达的预测效能。方法回顾性分析2015年4月至2021年8月就诊于天津医科大学肿瘤医院的72例患者的临床资料,所有患者均于术前行^(18)F-FDG PET/CT检查并经病理证实为乳腺癌,测量原发灶最大标准化摄取值(SUV_(max))、肿瘤代谢体积(MTV)、糖酵解总量(TLG),分析EGFR表达状态与^(18)F-FDG PET/CT代谢参数的相关性,通过受试者工作特征曲线(ROC)及Logistic回归分析评价原发灶^(18)F-FDG PET/CT显像代谢参数对EGFR阳性表达的预测效能。结果72例患者中EGFR阳性表达者29例,阴性表达者43例,EGFR阳性表达率为40.28%;EGFR阳性表达者SUV_(max)、TLG中位数分别为11.97、227.48,明显高于阴性者的7.00、27.72,差异均有统计学意义(P<0.05),MTV比较差异无统计学意义(P>0.05);在肿瘤直径>5 cm、ER阴性、PR阴性、三阴性乳腺癌以及T_(3-4)、Ⅲ~Ⅳ期中的EGFR阳性表达率明显高于肿瘤直径≤5 cm、ER阳性、PR阳性、非三阴性乳腺癌以及T_(1-2)、Ⅰ~Ⅱ期的EGFR阳性表达率,差异均有统计学意义(P<0.05);原发灶直径>5 cm、ER阴性、PR阴性、三阴性乳腺癌、T_(3-4)、Ⅲ~Ⅳ期的SUV_(max)明显高于直径≤5 cm、ER阳性、PR阳性、非三阴性乳腺癌、T_(1-2)、Ⅰ~Ⅱ期的SUV_(max),差异均有统计学意义(P<0.05);原发灶直径>5 cm、有淋巴结转移、T_(3-4)、Ⅲ~Ⅳ期的MTV、TLG明显高于直径≤5 cm、无淋巴结转移、T_(1-2)、Ⅰ~Ⅱ期的MTV、TLG,差异均有统计学意义(P<0.05);原发灶SUV_(max)、TLG对EGFR阳性表达预测效能的ROC曲线下面积AUC分别为0.773、0.695;SUV_(max)最佳预测界值为13.95,灵敏度为51.7%,特异度为93.0%;TLG最佳预测界值207.48,灵敏度为51.7%,特异度为88.4%;Logistic回归分析结果显示,SUV_(max)为EGFR阳性表达的主要相关因素(P<0.05)。结论不同临床病理特征乳腺癌患者的EGFR表达状态和代谢参数存在差异,且SUV_(max)、TLG与EGFR表达状态有关,对EGFR阳性表达具有良好的预测价值;SUV_(max)为EGFR阳性表达的主要相关因素;^(18)F-FDG PET/CT代谢参数能一定程度够反映乳腺癌EGFR表达状态,在乳腺癌临床诊疗中具有参考价值。
Objective To explore the correlation between EGFR expression and ^(18)F-fluorodeoxyglucose positron emission computed tomography(^(18)F-FDG PET/CT)metabolic parameters in patients with breast cancer,and to analyze the predictive efficacy of ^(18)F-FDG PET/CT metabolic parameters on the positive expression of EGFR in patients with breast cancer.Methods The clinical data of 72 patients who were treated in Tianjin Medical University Cancer Institute and Hospital from April 2015 to August 2021 were retrospectively analyzed.All patients underwent ^(18)F-FDG PET/CT examination before surgery and were pathologically confirmed to be breast cancer.According to PET/CT imaging data,the maximum standardized uptake value(SUV_(max)),metabolic tumor volume(MTV),and total lesion glycolysis(TLG)of primary lesions were measured automatically.The correlation of EGFR expression status and ^(18)F-FDG PET/CT metabolic parameters were analyzed,and the predictive performance of ^(18)F-FDG PET/CT metabolic parameters of primary tumor on EGFR positive expression was evaluated by receiver operating characteristic curve(ROC curve)and Logistic regression analysis.Results Among the 72 patients,29 had EGFR positive expression and 43 had negative expression,and the EGFR positive expression rate was 40.28%;the median values of SUV_(max) and TLG in patients with EGFR positive expression were 11.97 and 227.48,which were significantly higher than 7.00 and 27.72 in patients with EGFR negative expression(P<0.05);there was no significant difference in MTV(P>0.05).The EGFR positive expression rate in patients with tumor diameter>5 cm,ER-negative,PR-negative,triple-negative breast cancer,T_(3-4),Ⅲ-Ⅳstage was significantly higher than that in patients with tumor diameter≤5 cm,ER-positive,PR-positive,non-triple-negative breast cancer,T_(1-2),Ⅰ-Ⅱstage(P<0.05).The SUV_(max) of patients with tumor diameter>5 cm,ER-negative,PR-negative,triple-negative breast cancer,T_(3-4),Ⅲ-Ⅳstage was significantly higher than that of patients with diameter≤5 cm,ER-positive,PR-positive,non-triple-negative breast cancer,T_(1-2),Ⅰ-Ⅱstage(P<0.05).The MTV and TLG of patients with tumor diameter>5 cm,lymph node metastasis,T_(3-4),Ⅲ-Ⅳstage were significantly higher than those of patients with tumor diameter≤5 cm,no lymph node metastasis,T_(1-2),andⅠ-Ⅱstage(P<0.05).The area under the ROC curve(AUC)of primary tumor SUV_(max) and TLG for the prediction of EGFR positive expression were 0.773 and 0.695,respectively;the best predictive cutoff,sensitivity,specificity were 13.95,51.7%,93.0%for SUV_(max),and 207.48,51.7%,88.4%for TLG.Logistic regression analysis showed that SUV_(max) was the main factor related to EGFR positive expression(P<0.05).Conclusion There are differences in EGFR expression status and metabolic parameters in breast cancer patients with different clinic opathological characteristics,and SUV_(max) and TLG are related to EGFR expression status and have good predictive value for EGFR positive expression.SUV_(max) is the main factor related to EGFR positive expression.^(18)F-FDG PET/CT metabolic parameters can reflect the expression status of EGFR in breast cancer to a certain extent,and have reference value in the clinical diagnosis and treatment of breast cancer.
作者
彭新华
朱研佳
朱磊
徐文贵
PENG Xin-hua;ZHU Yan-jia;ZHU Lei;XU Wen-gui(Department of Molecular Imaging and Nuclear Medicine,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy of Tianjin,Tianjin’s Clinical Research Center for Cancer,Key Laboratory of Breast Cancer Prevention and Therapy,Ministry of Education,Tianjin 300060,CHINA)
出处
《海南医学》
CAS
2022年第21期2806-2810,共5页
Hainan Medical Journal
基金
天津市科技计划项目(编号:18PTZWHZ00100)
天津市自然科学基金(编号:18JCZDJC44700)。
关键词
乳腺癌
表皮生长因子受体
氟代脱氧葡萄糖
正电子发射计算机断层扫描
临床病理特征
相关性
Breast cancer
Epidermal growth factor receptor
18 F-fluorodeoxyglucose
Positron emission computed tomography(PET/CT)
Clinicopathological features
Relationship
作者简介
通讯作者:徐文贵,E-mail:wenguixy@163.com。
