乳腺浸润性导管癌18F-FDG摄取的影响因素分析

摘要

Objective: To determine the impact of size of foci, tumor grade, lymph node status, and estrogen receptor ( ER), progesterone receptor (PR), pro-oncogene-C-erbB-2, p53 and Ki67 status of infiltrating ductal carcinoma of breast on 18F-fluorodeoxyglucose ( FDG) uptake. Methods: All 37 consecutive women proved with ductal carcinoma received FDG PET/CT imaging and postsurgery immunohistoehemistry. Results; Several biological features of poor prognostic factors were associated with increase in FDG uptake: size=2. 5cm, higher grade (-) , lymph metastasis tumors had significantly higher SUVmxa(P <0.05); ER(-) and Ki67( + ) alw had significantly higher SUVmxa than ER (-) and Ki67 (-) (P < 0.05). However, there was no influence of PR, C-erbB-2, p53 on SUVmxa. Conclusion: Size tumor grade, lymph node status, ER, and Ki67 status of infiltrating ductal carcinoma of breast affects I8F-FDG uptake, these prognostic factors should be taken into account for differentiation and baseline staging with 18F-FDG PET/CT.%目的:探讨肿瘤大小、病理分级、有无淋巴结转移及病理分子标志物雌激素受体(ER)、孕激素受体(PR)、表发生长因子受体(C-erbB-2)、p53抑癌基因(p53)及增殖细胞核抗原Ki67( Ki67)对乳腺浸润性导管癌18F-FDG摄取的影响.方法:37例病理证实乳腺浸润性导管癌术前18F-FDG PET/CT SUVmax与术后病理免疫组化结果进行综合分析,采用Mann-Whitney U检验进行统计学分析.结果:病灶直径≥2.5cm、肿瘤高分化(Ⅲ级)、淋巴结转移组平均SUVmax分别高于＜2.5cm、低分化(Ⅰ-Ⅱ级)及淋巴结未转移有统计学意义(P＜0.05).ER(-)组18F-FDG摄取程度高于ER(+)组(P＜0.05),Ki67(+)组18F-FDG摄取程度高于Ki67(-)组,差异均有统计学意义(P＜0.05).而PR、C-erbB-2及p53对18F-FDG摄取影响不明显.结论:乳腺浸润性导管癌病灶大小、病理分级、有无淋巴结转移、ER、Ki67的表达影响18F-FDG摄取,18F-FDG PET/CT鉴别诊断及初步分期时应引起重视.