^(18)F-FDG PET/CT对乳腺癌随访疗效的评估及与Ki67和COX-2表达相关性的研究  

Study on the assessment of ^(18)F-FDG PET/CT for the curative effect of follow-up visit of breast cancer and the correlations between that and Ki67 expression and between that and COX-2 expression

作　　者：尹剑桥[1] 李午生[1] 刘彩刚[1] 邢飞[1] 于宏[1] 邱芳[1] YIN Jian-qiao;LI Wu-sheng;LIU Cai-gang(Oncology Department,Shengjing Hospital of China Medical University,Shenyang 110022,China;不详)

机构地区：[1]中国医科大学附属盛京医院肿瘤科,辽宁沈阳110022

出　　处：《中国医学装备》2021年第7期83-87,共5页China Medical Equipment

基　　金：国家自然科学基金(81872159)“FSIPI调控CD44-/CD24-三阴性乳腺癌细胞去分化为肿瘤干细胞的机制研究”。

摘　　要：目的:研究^(18)F-脱氧葡萄糖(^(18)F-FDG)PET/CT对乳腺癌随访疗效评估的价值及其与细胞增殖核抗原(Ki67)和环氧合酶2(COX-2)表达的相关性。方法:选取行乳腺癌手术治疗的137例患者资料,根据随访结果分为预后不良组(47例)和预后良好组(90例)。术前所有患者均进行^(18)F-FDG PET/CT显像,计算最大标准化摄取值(SUV_(max))。采集病理标本进行免疫组化染色,评估肿瘤组织Ki67和COX-2表达水平。绘制受试者工作特征(ROC)曲线,计算ROC曲线下面积(AUC),分析患者术后随访疗效。采用Kaplan-Meier法分析不同SUV_(max)患者预后情况,采用Spearman系数分析SUV_(max)与Ki67和COX-2表达的相关性。结果:在137例患者中复发29例(占21.17%)、转移18例(占13.14%),预后不良47例(占34.31%)。预后不良组SUV_(max)高于预后良好组,其差异有统计学意义(t=3.758,P<0.05);预后不良组Ki67和COX-2阳性率均高于预后良好组,其差异有统计学意义(x^(2)=7.709,x^(2)=6.086;P<0.05)。SUV_(max)判断乳腺癌患者预后AUC为0.743,以SUV_(max)>8.90为临界值时的灵敏度和特异度分别为61.70%和84.44%。Kaplan-Meier法分析结果中,SUV_(max)>8.90和SUV_(max)≤8.90的乳腺癌患者的预后不良率分别为60.47%和22.34%;SUV_(max)>8.90的乳腺癌患者Ki67和COX-2表达水平高于SUV_(max)≤8.90的患者,差异有统计学意义(Z=10.796,Z=12.083;P<0.05);乳腺癌患者SUV_(max)与Ki67和COX-2表达水平呈明显正相关(r=0.508,r=0.570;P<0.05)。结论:^(18)F-FDG PET/CT显像中SUV_(max)对乳腺癌随访疗效评估具有较高的参考价值,且与肿瘤组织Ki67和COX-2表达水平呈明显正相关。Objective:To study the value of ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography[(^(18)F-FDG)PET/CT]in the assessment of curative efficacy of breast cancer in follow-up visit,and the correlations between that and the expressions of proliferating cell nuclear antigen(Ki67)and between that and cyclooxygenase-2(COX-2),respectively.Methods:A total of 137 patients underwent surgery for breast cancer were selected and were divided into poor prognosis group(47 cases)and favorable prognosis group(90 cases)according to the results of followup.^(18)F-FDG PET/CT imaging was performed on all patients before surgery,and the maximum standardized uptake value(SUV_(max))was calculated.Pathological specimens were obtained by surgery for immumohistochemical staining,and the expression levels of Ki67 and COX-2 in tumor tissues were assessed.The curve of receiver operating characteristics(ROC)was drawn for calculating area under curve(AUC)of ROC curve,and then,the curative effect in follow-up post operation was further analyzed.Kaplan-Meier method was used to analyze the prognosis status of patients with different SUV_(max),and Spearman coefficient was used to analyze the correlations between SUV_(max) and expressions of Ki67 and COX-2,respectively.Results:In the 137 patients,there were recurrence in 29 cases(21.17%)and metastasis in 18 cases(13.14%),and poor prognosis in 47 cases(34.31%),respectively.The SUV_(max) in poor prognosis group was significantly higher than that in favorable prognosis group(t=3.758,P<0.05).The positive rates of Ki67 and COX-2 in poor prognosis group were significantly higher than those in favorable prognosis group(x^(2)=7.709,x^(2)=6.086,P<0.05).The AUC of SUV_(max) in judging the prognosis of patients with breast cancer was 0.743,and the sensitivity and specificity were 61.70% and 84.44% when taking SUV_(max)>8.90 as threshold,respectively.The results of Kaplan-Meier analysis showed that the poor prognosis rates of patients with breast cancer when SUV_(max) was larger than 8.90

关 键 词：乳腺癌 术后随访 疗效评估 ^(18)F-脱氧葡萄糖(^(18)F-FDG)PET/CT 细胞增殖核抗原(Ki67) 环氧合酶2(COX-2) 

分 类 号：R737.9[医药卫生—肿瘤]