Abstract
The relationship between 18F-FDG uptake and HER2 expression in colorectal cancer has not been investigated yet. This study aimed to investigate the predictive efficiency of preoperative 18F-FDG PET/CT for HER2 expression and prognosis in colorectal cancer. We retrospectively analyzed 131 colorectal cancer patients who underwent 18F-FDG PET/CT scans in our center before surgery. HER2 positivity was defined as a score of 2+ or 3+, and HER2 negativity was defined as a score of 0 or 1+ in immunohistochemistry of HER2 expression. The relationships between 18F-FDG PET/CT metabolic parameters and HER2 expression and the prognosis of colorectal patients were systematically studied. From 131 colorectal cancer patients, there were 27 (20.6%) HER2-positive patients. SUVmax of the primary tumor (mean ± SD) in the HER2-positive and the HER2-negative group was 18.238±8.912 and 14.455±6.531, respectively. SUVmax in the HER2-positive group was higher than in the negative group (p=0.034). When the cutoff was based on 5 cm, tumor size demonstrated significant positive correlations with SUVmax (p=0.012) and HER2 expression (p=0.014). Multivariate analysis showed that both SUVmax and tumor size had a significant correlation with HER2 expression (p=0.049 vs. p=0.043, respectively). There was no statistical difference in PFS between the HER2-positive and the HER2-negative group (p=0.28). 18F-FDG metabolic parameters had a significant correlation with HER2 expression in colorectal cancer. SUVmax combined with primary tumor size were better for predicting the HER2 status of colorectal cancer. 18F-FDG metabolic parameters had a significant correlation with HER2 expression in colorectal cancer. SUVmax combined with primary tumor size were better for predicting the HER2 status of colorectal cancer.
Highlights
Colorectal cancer (CRC) is one of the most commonly diagnosed cancer all over the world [1], its epidemiology is obviously different in various regions
The present study aimed to investigate whether human epidermal growth factor receptor 2 (HER2) expression is associated with 18F-FDG uptake and whether 18F-FDG PET/CT can be used to predict the HER2 status and prognosis of colorectal cancer
This was the first study to present evidence of the potential value of 18F-FDG PET/CT scans for this use and to suggest that 18F-FDG PET/CT may play a key role in determining the strategy for colorectal cancer patients by predicting their response to anti-HER2 antibody therapy
Summary
Colorectal cancer (CRC) is one of the most commonly diagnosed cancer all over the world [1], its epidemiology is obviously different in various regions. There are some practices to determine the HER2 expression in colorectal cancer patients, the procedures are invasive Alternative noninvasive strategies, such as PET/ CT, for predicting the mutation profile would be of great value. The present study aimed to investigate whether HER2 expression is associated with 18F-FDG uptake and whether 18F-FDG PET/CT can be used to predict the HER2 status and prognosis of colorectal cancer. To our knowledge, this was the first study to present evidence of the potential value of 18F-FDG PET/CT scans for this use and to suggest that 18F-FDG PET/CT may play a key role in determining the strategy for colorectal cancer patients by predicting their response to anti-HER2 antibody therapy
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