基于定量CT身体组分、^(18)F-FDG PET/CT显像预测手术联合新辅助化疗治疗早期乳腺癌预后的价值  

Prognostic value of surgery combined with neoadjuvant chemotherapy for early breast cancer based on quantitative CT body composition and ~(18)F-FDG PET/CT imaging

作　　者：白丽[1] 苏雪娟[1] 陈体[1] BAI Li;SU Xue-juan;CHEN Ti(Department of Radiology,Nanyang Second People's Hospital,Nanyang 473000,Henan,CHINA)

机构地区：[1]南阳市第二人民医院放射科,河南南阳473000

出　　处：《海南医学》2024年第5期713-718,共6页Hainan Medical Journal

基　　金：河南省南阳市2022年科技攻关项目(编号:KJGG076)。

摘　　要：目的 分析定量CT (QCT)身体组分、^(18)F-氟脱氧葡萄糖正电子发射型计算机断层显像(^(18)F-FDG PET-CT)对手术联合新辅助化疗(NAC)治疗早期乳腺癌患者预后的预测效能,为临床治疗提供参考。方法 选取2020年3月至2022年10月于南阳市第二人民医院接受手术联合NAC治疗的82例早期乳腺癌患者纳入研究,在NAC前和化疗1、3个周期后检测记录QCT参数[L_(1)、L_(2)水平的皮下脂肪面积(SFA)、内脏脂肪面积(VFA)、骨密度(BMD)、L_(3)水平的椎旁肌肉面积(TMA)]、^(18)F-FDG PET/CT显像的最大标准摄取值(SUV_(max))、肿瘤代谢体积(MTV)。NAC结束后进行手术,随访12个月(失访2例),依据有无复发转移分为预后良好组43例和预后不良组37例,比较不同预后患者的QCT参数、^(18)F-FDG PET/CT显像指标,采用受试者工作特征(ROC)曲线获取曲线下面积(AUC)分析其对早期乳腺癌患者预后的预测效能。结果化疗1个周期后,预后良好组患者的SFA、BMD、VFA、MA水平分别为(45.23±4.07) cm^(2)、(128.97±26.53) mg/m^(2)、(78.07±6.69) cm^(2)、(37.36±5.74) cm^(2),明显高于预后不良组的(42.52±3.32) cm^(2)、(112.54±25.82) mg/m^(2)、(73.73±7.25) cm^(2)、(32.94±5.31) cm^(2),差异均有统计学意义(P<0.05);化疗3个周期后,预后良好组患者的SFA、BMD、VFA、MA水平分别为(40.95±3.92) cm^(2)、(113.55±15.87) mg/m^(2)、(73.59±6.17) cm^(2)、(32.67±4.98) cm^(2),明显高于预后不良组的(37.51±3.56) cm^(2)、(95.18±17.45) mg/m^(2)、(70.30±5.14) cm^(2)、(28.52±4.42) cm^(2),差异均有统计学意义(P<0.05);化疗1个周期后,预后良好组患者的SUV_(max)、MTV分别为5.43±1.25、(3.86±0.87)×10^(4)mm,明显低于预后不良组的6.04±1.07、(4.27±0.85)×10^(4)mm,差异均有统计学意义(P<0.05);化疗3个周期后,预后良好组患者的SUV_(max)、MTV分别为3.94±1.06、(2.61±0.70)×10^(4)mm,明显低于预后不良组的4.73±1.21、(3.05±0.93)×10^(4)mm,差异均有统计学意义(P<0.Objective To analyze the predictive effect of quantitative CT (QCT) body composition and~(18)F-fluorodeoxyglucose positron-emission tomography compared with computed tomography (~(18)F-FDG PET/CT) imaging on the prognosis of early breast cancer patients treated with surgery combined with neoadjuvant chemotherapy (NAC),and provide reference for clinical treatment.Methods A total of 82 patients with early breast cancer who received surgery combined with NAC in Nanyang Second People's Hospital from March 2020 to October 2022 were selected,QCT parameters[subcutaneous fat area (SFA) at L_(1and) L_2levels,visceral fat area (VFA),bone density (BMD),paraspinal muscle area (TMA) at L_3levels],maximum standard uptake value (SUV max) of~(18)F-FDG PET/CT imaging,and tumor metabolic volume (MTV) were measured and recorded before NAC,1 cycle,and 3 cycles after chemotherapy.After NAC,the operation was carried out.The patients were followed up for 12 months (2 cases were lost).They were divided into a good prognosis group of 43 cases and a poor prognosis group of 37 cases according to whether there was recurrence and metastasis.The QCT parameters,~(18)F-FDG PET/CT imaging indicators of patients with different prognosis were compared.The area under the curve (AUC) obtained from the receiver operating characteristics (ROC) curve was used to analyze its predictive efficacy for the prognosis of early breast cancer patients.Results Thirty seven patients with early breast cancer had metastasis and recurrence in the follow-up.The levels of SFA,BMD,VFA,and MA in patients with a good prognosis after one cycle of chemotherapy were (45.23±4.07) cm^(2),(128.97±26.53) mg/m^(2),(78.07±6.69) cm^(2),and (37.36±5.74) cm^(2),respectively,which were significantly higher than (42.52±3.32) cm^(2),(112.54±25.82) mg/m^(2),(73.73±7.25) cm^(2),and (32.94±5.31) cm^(2)in patients with a poor prognosis (P<0.05).The levels of SFA,BMD,VFA,and MA in patients with a good prognosis after 3 cycles of chemotherapy were (40.95±3.92) cm^(2),(113.55±15.87)

关 键 词：乳腺癌 ^(18)F-氟脱氧葡萄糖正电子发射型计算机断层显像 定量CT 新辅助化疗 骨密度 肿瘤代谢体积 

分 类 号：R737.9[医药卫生—肿瘤]