AUTHOR=Zhu Lei , Yang Xin , Zhang Jiying , Wang Shuling , Wang Yulong , Wan Xing , Zhu Xiang , Song Xiuyu , Tong Zhongsheng , Yang Meng , Zhao Weipeng 

TITLE=Evaluation of prognostic risk factors of triple-negative breast cancer with 18F-FDG PET/CT parameters, clinical pathological features and biochemical indicators

JOURNAL=Frontiers in Cell and Developmental Biology

VOLUME=12

YEAR=2024

URL=https://www.frontiersin.org/journals/cell-and-developmental-biology/articles/10.3389/fcell.2024.1421981

DOI=10.3389/fcell.2024.1421981

ISSN=2296-634X

ABSTRACT=<sec><title>Introduction</title><p>Breast cancer is a heterogeneous disease comprising various molecular subtypes, including Luminal A, Luminal B, human epidermal growth factor receptor-2 (HER2) positive, and triple negative types, each with distinct biological characteristics and behaviors. Triple negative breast cancer (TNBC) remains a particularly challenging subtype worldwide. Our study aims to evaluate whether Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (<sup>18</sup>F-FDG PET/CT) parameters, clinical pathological features, and biochemical indicators serve as prognostic risk factors for TNBC. Additionally, we explore correlations between biochemical indicators and <sup>18</sup>F-FDG PET/CT parameters.</p></sec><sec><title>Methods</title><p>We conducted a retrospective analysis of 95 TNBC patients who underwent preoperative <sup>18</sup>F-FDG PET/CT examinations at Tianjin Medical University Cancer Institute and Hospital from 2013 to 2018. Collected data included <sup>18</sup>F-FDG PET/CT parameters, clinical and pathological features, and biochemical indicators. We used Kaplan-Meier survival analysis and multivariate Cox regression analysis to evaluate associations between <sup>18</sup>F-FDG PET/CT parameters/biochemical indicators and disease free survival (DFS)/overall survival (OS). The log-rank test determined significant differences in survival curves, and the Spearman correlation coefficient analyzed correlations between quantitative variables. Visualization and analysis were performed using R packages.</p></sec><sec><title>Results</title><p>Among 95 TNBC patients, mean standardized uptake value (SUV<sub>mean</sub>) was significantly correlated with DFS. Fasting blood glucose (FBG), α- L-fucosylase (AFU) and Creatine kinase (CK) were independent predictors of DFS, while Precursor albumin (PALB) and CK were independent predictors of OS. FBG showed correlations with SUV<sub>peak</sub> and SUV<sub>mean</sub>, and CK was correlated with peak standardized uptake value (SUV<sub>peak</sub>). Our results indicated that <sup>18</sup>F-FDG PET/CT parameters and biochemical indicators may constitute a new prognostic model for TNBC patients post-surgery.</p></sec><sec><title>Discussion</title><p>We found that SUV<sub>mean</sub>, FBG, AFU and CK are predictive factors for DFS in TNBC patients post-surgery, while PALB and CK are predictive factors for OS, which prompts us to pay more attention to these indicators in clinical practice. Also <sup>18</sup>F-FDG PET/CT parameters and biochemical indicators have potential utility in constituting a new prognostic model for TNBC patients post-surgery.</p></sec>