Higashi Tatsuya, Saga Tsuneo, Nakamoto Yuji, Ishimori Takayoshi, Mamede Marcelo H, Wada Michihiko, Doi Ryuichiro, Hosotani Ryo, Imamura Masayuki, Konishi Junji
Department of Nuclear Medicine and Diagnostic Imaging, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Nucl Med. 2002 Feb;43(2):173-80.
Recently, some studies have shown that delayed scanning with (18)F-FDG PET may help to differentiate malignant from benign pancreatic lesions. However, no study has evaluated the relationship between temporal changes in (18)F-FDG uptake and expression of hexokinase or glucose transporter.
Twenty-one consecutive patients with pancreatic cancer were studied preoperatively by dual-phase (18)F-FDG PET, performed 1 and 2 h after injection of (18)F-FDG. The standardized uptake value (SUV) of the pancreatic cancer was determined, and the retention index (RI) (%) was calculated by subtracting the SUV at 1 h (SUV1) from the SUV at 2 h (SUV2) and dividing by SUV1. The percentages of cells strongly expressing hexokinase type-II (HK-II) and glucose transporter-1 (GLUT-1) were scored on a 5-point scale (1 = 0%-20%, 2 = 20%-40%, 3 = 40%-60%, 4 = 60%-80%, 5 = 80%-100%) by visual analysis of immunohistochemical staining of paraffin sections from the tumor specimens using anti-HK-II and anti-GLUT-1 antibody (HK-index and G-index, respectively).
SUV2 (mean +/- SD, 5.7 +/- 2.6) was higher than SUV1 (5.1 +/- 2.1), with an RI of 8.5 +/- 11.0. Four cases of cancer, in which SUV2 showed a decline from SUV1, showed a low HK-index (1.8 +/- 1.1), whereas 4 cases with an RI of > or =20 and 13 cases with an intermediate RI (0-20) showed significantly higher HK-indices (4.3 +/- 0.7 and 3.1 +/- 1.5, respectively; P < 0.05). RI showed a positive correlation with HK-index, with an R(2) of 0.27 (P < 0.05), but no significant correlation with the G-index. SUV1 showed no relationship with the HK-index but showed a weak positive correlation with the G-index, with an R(2) of 0.05 (P = 0.055).
These preliminary findings suggest that the RI obtained from dual-phase (18)F-FDG PET can predict HK-II expression and that the SUV (at 1 h) has a positive correlation with GLUT-1 expression but not with HK-II expression.
最近，一些研究表明，（18）F-FDG PET延迟扫描可能有助于鉴别胰腺良恶性病变。然而，尚无研究评估（18）F-FDG摄取的时间变化与己糖激酶或葡萄糖转运蛋白表达之间的关系。
连续21例胰腺癌患者在术前接受双期（18）F-FDG PET检查，在注射（18）F-FDG后1小时和2小时进行。测定胰腺癌的标准化摄取值（SUV），并通过用2小时时的SUV（SUV2）减去1小时时的SUV（SUV1），再除以SUV1来计算滞留指数（RI）（%）。使用抗HK-II和抗GLUT-1抗体（分别为HK指数和G指数），通过对肿瘤标本石蜡切片免疫组化染色的视觉分析，对强表达II型己糖激酶（HK-II）和葡萄糖转运蛋白-1（GLUT-1）的细胞百分比进行5分制评分（1 = 0%-20%，2 = 20%-40%，3 = 40%-60%，4 = 60%-80%，5 = 80%-100%）。
SUV2（均值±标准差，5.7±2.6）高于SUV1（5.1±2.1），RI为8.5±11.0。4例SUV2较SUV1下降的癌症病例HK指数较低（1.8±1.1），而4例RI≥20的病例和13例RI为中间值（0-20）的病例HK指数显著较高（分别为4.3±0.7和3.1±1.5；P<0.05）。RI与HK指数呈正相关，R²为0.27（P<0.05），但与G指数无显著相关性。SUV1与HK指数无相关性，但与G指数呈弱正相关，R²为0.05（P = 0.055）。
这些初步研究结果表明，双期（18）F-FDG PET获得的RI可预测HK-II的表达，且SUV（1小时时）与GLUT-1表达呈正相关，但与HK-II表达无关。
