Visceral fat metabolic activity evaluated by preoperative 18F-FDG PET/CT significantly affects axillary lymph node metastasis in postmenopausal luminal breast cancer

Figures

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  Figure 1. Representative images of visceral adipose tissue (VAT) metabolic activity according to the axillary lymph node (ALN) metastasis status (A) and its corresponding magnified VAT images (B). N(−); negative ALN metastasis, N(+); positive ALN metastasis, CT; computed tomography, PET: positron emission tomography.

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  Figure 2. Comparison of (A,E) VAT SUVmax, (B,F) SAT SUVmax, (C,G) V/S ratio, and (D,H) Tumor SUVmax according to the ALN metastasis status in postmenopausal luminal and non-luminal breast cancer patients. Luminal breast cancer (A–D). N(−), n = 74; N(+), n = 57. Non-luminal breast cancer (E–H). N(−), n = 34; N(+), n = 8. *Statistically significant difference. N(−); negative ALN metastasis, N(+); positive ALN metastasis, SUVmax; maximum standardized uptake value, SAT; subcutaneous adipose tissue, V/S ratio; VAT SUVmax/SAT SUVmax. (A–H); p-values were determined by using Mann-Whitney U test.

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  Figure 3. Comparison of (A,E) VAT SUVmax, (B,F) SAT SUVmax, (C,G) V/S ratio, and (D,H) Tumor SUVmax according to the ALN metastasis status in postmenopausal luminal A and B breast cancer patients. (I,J) Receiver operating characteristic (ROC) curve analysis for the prediction of ALN metastasis. Luminal A breast cancer (A–D, and I). N(−), n = 45; N(+), n = 33. Luminal B breast cancer (E–H, and J). N(−), n = 29, n =24. * Statistically significant difference. (A–H); p-values were determined by using Mann-Whitney U test.

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  Figure 4. The effect of hormone replacement therapy (HRT) on (A) VAT SUVmax, (B) SAT SUVmax, and (C) V/S ratio in N(−) and (D) VAT SUVmax, (E) SAT SUVmax, and (F) V/S ratio in N(+) postmenopausal luminal breast cancer patients. (N−), n =p74, HRT(−), n = 60, HRT(+), n = 14; N(+), n = 57, HRT(−), n = 44, HRT(+), n = 13. HRT(−); patients without the use of HRT, HRT(+); patients with current HRT use. (A–F); p-values were determined by using Mann-Whitney U test.

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  Figure 5. Comparison of erythrocyte sedimentation rate (ESR) according to the ALN metastasis status in (A) luminal type, (B) luminal A, and (C) luminal B breast cancer patients. (A) N(−), n = 74; N(+), n = 57, (B) N(−), n = 45; N(+), n = 33, (C) N(−), n = 29; N(+), n = 24. (A–C); p-values were determined by using Mann-Whitney U test.