39P - Prognostic significance of hypoxic microenvironment biomarkers in invasive ductal breast cancer

Background

This study aims to investigate the immunohistochemical expression of HIF-1α, GLUT1, and CA IX in patients with invasive ductal breast cancer (IDC) and assess their correlation with the maximum standardized uptake value of the primary tumor (pSUVmax) and other biological parameters. Additionally, the prognostic significance of pSUVmax, HIF-1α, GLUT1, and CA IX in predicting progression-free survival (PFS) will be evaluated.

Methods

A total of 174 female patients with IDC who underwent pretreatment F-18 FDG PET/CT were enrolled in this study. The pSUVmax was compared with clinicopathological parameters, including estrogen receptor (ER), progesterone receptor (PR), HER2 status, axillary lymph node metastasis (LNM), cancer stage, GLUT1, CA IX, and HIF-1α. The prognostic value of pSUVmax, GLUT1, CA IX, and HIF-1α for PFS was analyzed using the Kaplan-Meier method.

Results

The study revealed that pSUVmax was significantly higher in patients with HIF-1α≥2, GLUT1≥5, and CA IX≥3, compared to patients with HIF-1α<2, GLUT1<5, and CA IX<3 (4.9±4.1 vs. 3.9±3.2, P=0.02; 6.1±4.2 vs. 3.5±3.0, P=0.003; 5.9±4.5 vs. 3.8±3.2, P=0.003). Furthermore, patients with disease progression had significantly higher pSUVmax values than those who remained disease-free (6.4±3.5 vs. 4.1±3.6, P=0.0045). Receiver-operating characteristic (ROC) curve analysis identified optimal cutoff values for predicting PFS as pSUVmax of 6.8, GLUT1 of 5, and CA IX of 3, with corresponding sensitivities and specificities. Kaplan-Meier analysis revealed that pSUVmax ≥6.8 (P=0.0004), GLUT1≥5 (P=0.0005), and CA IX≥3 (P<0.0001) were predictive of recurrence.

Conclusions

The study findings indicate that pSUVmax on pretreatment F-18 FDG PET/CT can serve as a reliable surrogate marker for predicting progression in patients with IDC. Increased FDG uptake is associated with higher expression levels of HIF-1α, GLUT1, and CA IX, indicating the presence of glucose metabolism and hypoxia in breast cancer cells. These biomarkers hold promise for improved cancer detection and prognostication in IDC patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.