新型^(18)F-FES PET/CT无创功能性诊断乳腺癌迟发性肺转移致霍纳综合征一例  

Novel 18 F⁃FES PET/CT in Non⁃invasive Functional Diagnosis of Delayed Lung Metastasis Presented with Horner Syndrome in a Metastatic Breast Cancer Patient

作　　者：姚儒[1] 郝志鑫 屈洋[1] 张超 李唯佳 郎洁 潘博[1] 周易冬[1] 孙强[1] 霍力[2] YAO Ru;HAO Zhixin;QU Yang;ZHANG Chao;LI Weijia;LANG Jie;PAN Bo;ZHOU Yidong;SUN Qiang;HUO Li(Department of Breast Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Nuclear Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Breast Surgery,Beijing LongFu Hospital,Beijing 100010,China)

机构地区：[1]中国医学科学院北京协和医院乳腺外科,北京100730 [2]中国医学科学院北京协和医院核医学科,北京100730 [3]北京市隆福医院乳腺外科,北京100010

出　　处：《协和医学杂志》2024年第3期702-707,共6页Medical Journal of Peking Union Medical College Hospital

基　　金：中央高水平医院临床科研专项(2022-PUMCH-A-165,2022-PUMCH-B-039);中国医学科学院医学与健康科技创新工程(2021-I2M-1-014)。

摘　　要：激素受体阳性、人表皮生长因子受体2型阴性(HR^(+)/HER2^(-))乳腺癌是最常见的乳腺癌分子亚型,可表现为术后10~15年以上的迟发性复发,且其肺转移病灶需与原发性肺癌相鉴别。本文报道1例HR^(+)/HER2^(-)乳腺癌术后16年迟发性肺转移致霍纳综合征患者,采用^(18)F-FDG PET/CT难以判断肿瘤来源,穿刺活检风险高,经北京协和医院新型^(18)F-FES PET/CT无创功能性诊断为乳腺癌肺上叶雌激素受体(estrogen receptor,ER)阳性转移,给予CDK4/6抑制剂+芳香化酶抑制剂内分泌解救治疗后获得缓解。本文总结该患者的临床表现及诊治经过,为新型^(18)F-FES PET/CT评估乳腺癌患者转移灶的ER表达情况及指导后续个体化诊疗提供借鉴。Hormonal receptor positive human epidermal receptor 2 negative(HR^(+)/HER2^(-))commonest molecular subtype of breast cancer(BC).Patients with HR^(+)/HER2^(-)BC may manifest clinically a late recurrence whose BC metastasizes 10-15 years post-operatively.We report one case who presented with pulmonary mass in upper lobe of lung and Horner syndrome 16 years after BC surgery.FDG PET/CT suggested pulmonary malignancy but could not differentiate between primary or metastatic cancer when invasive biopsy was quite risky.Novel 18 F-FES PET/CT facilitated the non-invasive functional diagnosis of estrogen-receptor positive(ER^(+))pulmonary metastasis of BC,and the patient experienced partial response(PR)after CDK4/6 inhibitor and aromatase inhibitor as endocrine therapy.This article reviews the diagnosis and treatment process of this case,to provide guidance for non-invasive global evaluation of ER status among metastatic HR^(+)/HER2^(-)BC patients with ^(18)F-FES PET/CT.

关 键 词：乳腺癌 ^(18)F-FES PET/CT 肺转移 霍纳综合征 雌激素受体 

分 类 号：R737.9[医药卫生—肿瘤] R734.2[医药卫生—临床医学]