Résumé
【Objective】 To analyze the correlation between metabolic parameters of 18F-deoxyglucose-labeledpositron emission tomography/computed tomography（18F-FDG PET/CT） scan and the immunohistochemistry （IHC） expression in patients with primary breast cancer so as to explore the predictive value of the metabolic parameters for molecular subtypes. 【Methods】 We retrospectively recruited 97 patients who underwent 18F-FDG PET/CT scan from November 2016 to June 2020 with breast cancer. The clinical stages （Ⅰ,Ⅱ,Ⅲ and Ⅳ） and menstrual status （pre-menopause or menopause） were collected. Metabolic parameters， including the maximum standardized uptake value （SUVmax）， mean standardized uptake value （SUVmean）， metabolic tumor volume （MTV） and total lesion glycolysis （TLG） of the primary tumor， were calculated by physician according to the 40% SUVmax principle. The IHC expressions （positive or negative） of the estrogen receptor （ER）， progesterone receptor （PR）， human epidermal growth factor receptor 2 （HER2）， proliferating cell nuclear antigen （Ki-67） and p53； the ipsilateral axillary lymph node metastasis （with or without）， and the molecular subtypes （Luminal A， Luminal B， HER2 overexpression， and triple negative） were determined by an experienced pathologist. The correlations between the metabolic parameters and IHC expression were analyzed by Pearson test or Spearman test， and were further stratified by different menstrual status and ipsilateral axillary lymph node metastasis. Finally， we analyzed metabolic parameters among different molecular subtypes. 【Results】 For all the patients， SUVmax and SUVmean had significantly negative correlation with ER and PR expressions （P<0.05）； SUVmax， SUVmean， and TLG were significantly positively correlated with Ki-67 expression （P<0.05）. SUVmax， SUVmean， and TLG of premenopausal patients （n=57） were negatively correlated with ER and PR expressions （P<0.05）， but positively correlated with Ki-67 expression （P<0.05）. MTV， TLG and PR expressions in postmenopausal patients （n=40） were positively correlated （P<0.05）. In patients with （n=27） or without （n=57） ipsilateral axillary lymph node metastasis， Ki-67 was negatively correlated with SUVmax and SUVmean （P<0.05）； in patients without ipsilateral axillary lymph node metastasis， SUVmax， SUVmean， and TLG were negatively correlated with PR （P<0.05）. Among different molecular types， SUVmax of HER2 overexpression was significantly higher than that of Luminal A （P<0.05）. 【Conclusion】 The 18F-FDG PET/CT metabolic parameters of breast cancer patients have a good correlation with the expression of immunohistochemistry， and SUVmax has predictive value for the expression of hetergeneous molecular types.
Résumé
OBJECTIVES: The purpose of this study was to examine the changes in metabolic parameters and Positive and Negative Syndrome Scale (PANSS) scores of patients previously treated with atypical antipsychotic drugs other than paliperidone, after 8 weeks of treatment with paliperidone. METHODS: Changes in body weight, body mass index, leptin, lipid levels, fasting glucose, and PANSS scores of patients who switched from other atypical antipsychotic drugs to paliperidone were measured after 8 weeks of treatment with paliperidone. We compared these results with those of patients who had not been treated with antipsychotic drugs for at least 2 weeks prior to treatment with paliperidone (antipsychotic drug-free patients). RESULTS: The antipsychotic drug-free group (n = 9) did not show significant changes in metabolic parameters, but showed a significant improvement in total and subscale scores of PANSS. In the group that switched from other atypical antipsychotic drugs to paliperidone (n = 13), body weight, body mass index and fasting glucose level significantly increased, while total and subscale scores of PANSS significantly improved. CONCLUSIONS: Paliperidone treatment will benefit patients with schizophrenia who have been antipsychotic drug-free or who have had difficulty with other atypical antipsychotic drugs, with regard to their psychopathological state. However, if patients have been treated with other atypical antipsychotic drugs before switching to paliperidone, they could gain body weight or their fasting glucose level could increase over a short period because of a change in receptor number and sensitivity caused by the previously prescribed antipsychotic drugs, and hence, paliperidone should be prescribed with caution for these patients.