Relationship between the semi-quantitative index of 99Tcm-3PRGD2 SPECT/CT imaging and clinical pathological features of breast cancer

Abstract

Objective To investigate the tumor/non-tumor (T/NT) ratio during 99Tcm-hydrazinonicotinamide(HYNIC)-(poly-(ethylene glycol), PEG)4-Glu(cyclo(Arg-Gly-Asp-D-Phe-Lys(PEG4)))2 (99Tcm-3PRGD2) SPECT/CT imaging and clinical pathological features of breast cancer. Methods Forty-five female patients (age range: 39-76 (53.0±9.5) years) with suspected breast malignant nodules or masses from October 2016 to June 2017 were prospectively enrolled. Patients underwent 99Tcm-3PRGD2 SPECT/CT imaging before breast puncture and surgery. All subjects had pathological results, and estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2(HER-2), Ki-67 and microvessel density (MVD) were obtained by immunohistochemistry and fluorescence in situ hybridization (FISH). Two-sample t test and Kruskal-Wallis H test were used to analyze the data. Results Invasive ductal carcinoma was pathologically confirmed in 35 of 45 patients. There were 7 patients in stage Ⅰ, 11 patients in stage ⅡA and 17 patients in stage ⅡB. The Luminal A subtype, Luminal B subtype, ERBB2+ subtype, Basal-like subtype were found in 6, 9, 9 and 11 patients, respectively. The T/NT ratio was significantly higher in the stage Ⅱ B patients than that in stage Ⅰ+ ⅡA patients (4.54±1.46 vs 3.32±1.72, t=-2.24, P<0.05). Patients with ERBB2+ subtype had higher T/NT ratio compared to patients with Basal-like subtype: 5.80(3.90, 6.70) vs 2.80(2.20, 3.50), H=11.06, χ2=15.31, both P<0.05. Besides, the T/NT ratios in the HER-2 positive group and lymphatic metastasis group were significantly higher than those in the HER-2 negative group and group without lymph node metastasis (t values: -3.99, -2.51, both P<0.05). MVD of HER-2 positive group was higher than that of HER-2 negative group (t=7.13, P<0.01). Conclusion The T/NT ratio during 99Tcm-3PRGD2 SPECT/CT imaging has relations with TNM staging, lymph node infiltration and HER-2 in breast cancer. Key words: Breast neoplasms; Tomography, emission-computed, single-photon; Tomography, X-ray computed; Arg-Gly-Asp