18F-FES PET/CT显像在雌激素受体阳性乳腺癌诊疗中的初步应用

Application of 18F-FES PET/CT in diagnosis and endocrine therapy of patients with estrogen receptor-positive breast cancer

    摘要
  • 摘要:
    目的 探讨16α-18F氟-17β-雌二醇（18F-FES）PET/CT显像在乳腺癌诊疗中的应用价值。
    方法 对19例乳腺癌术前患者、7例乳腺癌术后转移患者行18F-FDG、18F-FES PET双显像剂显像，并与雌激素受体（ER）的表达情况进行对照分析。
    结果 19例乳腺癌术前患者中，乳腺癌原发灶ER阳性者9例，共10个病灶，18F-FES最大标准化摄取值（SUVmax）为3.45±2.34，与病灶的ER表达水平及病灶大小均密切相关；ER阴性者10例，共11个病灶，18F-FES SUVmax为0.74±0.12，两组间差异有统计学意义（t=3.782，P < 0.01）。而ER阳性者和阴性者的18F-FDG SUVmax与病灶的ER表达水平无关。18F-FES PET/CT诊断原发灶ER阳性的灵敏度、特异度、准确率分别为100%、90.90%、95.23%。在7例术后转移患者中，原发灶ER阳性者3例，18F-FES共发现64个转移灶，而18F-FDG仅发现47个。
    结论 18F-FES PET/CT在ER阳性乳腺癌的特异性诊断、个性化治疗方案制定、疗效观察中具有非常重要的临床意义。

     

    Abstract:
    Objective To evaluate the role of 16α-18Ffluoro-17β-oestradiol(18F-FES)PET/CT in the diagnosis and management of breast cancer.
    Methods Nineteen pre-operation cases with breast cancer and 7 post-operation cases with metastatic breast cancer underwent 18F-FES PET/CT and 18F-FDG PET/CT, and comparative analysis with the expression of estrogen receptor(ER)was performed.
    Results Of the primary lesions, the ER was positive in 9 patients(10 lesions), negative in 10 patients(11 lesions). The maximum standardized uptake value(SUVmax) for FES uptake was positively related to the lesion size and ER expression. The mean SUVmax for FES uptake was 3.45±2.34 in the 10 ER positive tumors, and 0.74±0.12 in the 11 ER negative tumors, which showed significant differences between the two groups(t=3.782, P < 0.01). The sensitivity, specificity and accuracy of FES PET for diagnosis ER positive patients were 100%, 90.90% and 95.23% respectively. Sixty-four 18F-FES positive metastases were found in the three ER positive metastatic patients, whereas only 47 18F-FDG positive metastases were found.
    Conclusion 18F-FES PET/CT will be useful for diagnosis, individualized medicine and detecting therapeutic changes in patients with ER positive breast cancer.

     

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