Correlation Study of ¹⁸F-FDG PET-CT SUV_max, ER, PR, HER-2, Ki-67 and p53 during neoadjuvant chemotherapy in breast cancer

Objectives Comparison of the statistical difference between maximum standard uptake value (SUV_max) before neoadjuvant chemotherapy(NAC), SUV_max change rate(⊿SUV_max1%) after the first cycle of NAC , SUV_max change rate(⊿SUV_max2%) after the second cycle of NAC and status of ER, PR, HER-2, Ki-67, p53 expression in breast cancer.To explore the inner link between FDG uptake and molecular biological markers.

Methods Retrospective study of 211 cases of newly diagnosed breast cancer patients which performed ¹⁸F-FDG PET-CT at the baseline, 49 cases performed PET-CT after the first cycle of NAC, 49 cases performed PET-CT after the second cycle of NAC. The SUV_max and the rate of change was calculated. Tissue specimens from patients were immunohistochemically stained for ER, PR, HER-2, Ki-67 and p53.

Results The results show (Table 1), SUV_max in ER negative group was significantly higher than in ER positive group (p=0.000). SUV_max in PR negative group was significantly higher than in PR positive group (p=0.001). ⊿SUV_max2% in PR negative group was higher than in PR positive group(p=0.026). SUV_max, ⊿SUV_max2% in Ki-67 positive group was higher than in Ki-67 negative group(p=0.000, 0.022 respectively). There was no statistically difference among SUV_max, ⊿SUV_max1%, ⊿SUV_max2% in p53 and HER-2 negative group and in p53 and HER-2positive group (p=0.561, 0.920, 0.594 respectively).

Conclusions FDG metabolic of ER, PR negative patients was higher than ER, PR positive patients. ⊿SUV_max2% in PR negative patients was higher than PR positive patients, it suggests PR negative patients are more sensitive to NAC. SUV_max of Ki-67 positive group was higher than Ki-67 negative group, suggesting FDG metabolic may reflect the proliferation of tumor. Ki-67 positive patients had a higher ⊿SUV_max2%, it means Ki-67 positive patients are more sensitive to NAC.