Torizuka Tatsuo, Zasadny Kenneth R., Wahl Richard L.
Division of Nuclear Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
Clin Positron Imaging. 1999 Oct;2(5):281-287. doi: 10.1016/s1095-0397(99)00029-1.
To compare kinetics and accumulation of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) in primary lung cancer between diabetic and non-diabetic patients using positron emission tomography (PET).METHODS: Five diabetic patients and 21 non-diabetic patients underwent dynamic FDG-PET to image untreated primary lung cancers. Standardized uptake value normalized for lean body mass (SUL) was determined in tumor, blood, muscle, and lung. A 3-compartment metabolic model was applied to FDG kinetics in tumors in 24 of 26 patients.RESULTS: At the time of PET scans, serum glucose levels were elevated in 5 diabetic patients, while 21 non-diabetic patients showed normal glucose levels. In diabetic patients, tumor SUL, tumor/blood and tumor/muscle SUL ratios were significantly decreased (P < 0.02) and also tumor/lung SUL ratio declined (P = 0.064), as compared to non-diabetic patients. In addition, the rate constant for FDG phosphorylation (k3) and influx constant (Ki) in diabetic patients were significantly lower than those in non-diabetic patients (P < 0.02).CONCLUSION: In diabetic patients, the rate of FDG accumulation in tumors is decreased, and tumor targeting with FDG is impaired. Diabetes may reduce the sensitivity of FDG-PET for lung cancer detection.
使用正电子发射断层扫描（PET）比较糖尿病患者和非糖尿病患者原发性肺癌中2-[氟-18]-氟-2-脱氧-D-葡萄糖（FDG）的动力学和蓄积情况。
5例糖尿病患者和21例非糖尿病患者接受了动态FDG-PET检查，以对未经治疗的原发性肺癌进行成像。测定肿瘤、血液、肌肉和肺中经瘦体重标准化的标准化摄取值（SUL）。对26例患者中的24例患者的肿瘤FDG动力学应用三室代谢模型。
在PET扫描时，5例糖尿病患者的血清葡萄糖水平升高，而21例非糖尿病患者的葡萄糖水平正常。与非糖尿病患者相比，糖尿病患者的肿瘤SUL、肿瘤/血液和肿瘤/肌肉SUL比值显著降低（P<0.02），肿瘤/肺SUL比值也下降（P=0.064）。此外，糖尿病患者中FDG磷酸化的速率常数（k3）和流入常数（Ki）显著低于非糖尿病患者（P<0.02）。
在糖尿病患者中，肿瘤内FDG的蓄积速率降低，FDG的肿瘤靶向性受损。糖尿病可能会降低FDG-PET检测肺癌的敏感性。
