Relationship Between 18F-FDG Uptake with Clinicopathological Prognostic Factors and Biological Subtypes in Breast Cancer

Abstract

18 F-Fluorodeoxyglucose-positron-emission tomography ( 18 F-FDG PET) is used to evaluate the glucose metabolic rates of tumors. Several studies have reported that high 18 F-fluorodeoxyglucose uptake is predictive of poor prognosis and aggressive features in patients with breast cancer. This study aimed to observe the relationships between different metabolic parameters with clinicopathological prognostic factors (CPFs) and immunohistochemically defined biological subtypes (IHC-BS) in breast cancer and it may have considerable clinical applications. This case series analysis is a research of the cases of 120 consecutive women patients with invasive breast carcinoma who had undergone surgery and 18 F-fluorodeoxyglucose-positron-emission tomography preoperatively. Maximum and mean standardized uptake values (SUV max, SUV mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) in the primary tumor were calculated and compared with clinicopathological prognostic factors and immunohistochemically defined biological subtypes. A significant correlation was found between maximum and mean standardized uptake values with hormone receptor status (estrogen and progesterone receptor), other* histological diagnosis group, triple-negative molecular subgroup, Ki67 proliferation index, and nodal metastasis ( p < 0.05). At the same time, there was a significant correlation between the number of primary tumors, nodal metastasis, and high c-stage with metabolic tumor volume and total lesion glycolysis ( p < 0.05). Between the number of primary tumors and neutrophil/lymphocyte ratio (NLR) were positively correlated ( p < 0.05). The present study demonstrated that the finding of high preoperative 18 F-Fluorodeoxyglucose uptake in breast cancer may be reflective of high c-stage and poor prognostic molecular subgroups and high neutrophil/lymphocyte ratio may be predictive of multifocal or multicentric tumor among patients with breast cancer. On the other hand, among patients with breast cancer with high maximum standardized uptake values in the primary tumor, neoadjuvant chemotherapy may be more convenient or high neutrophil/lymphocyte ratio values may be effective in determining the surgical technique to be chosen.