Department of Internal Medicine, Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
J Thorac Oncol. 2011 Oct;6(10):1697-703. doi: 10.1097/JTO.0b013e318226b677.
Previous studies have shown that lung squamous cell carcinoma has higher ¹⁸F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) than adenocarcinoma. We hypothesized that histological subtypes of lung adenocarcinoma were also different in ¹⁸F-FDG uptake.
Patients who had preoperative PET/computed tomography (CT) scan and had undergone complete resection for lung adenocarcinoma between April 2007 and December 2009 were enrolled in this study. Because of the limitation of spatial resolution on PET/CT, tumors less than 1 cm were excluded for analysis. Two independent classification systems were used to categorize histological subtypes of adenocarcinoma; one was modified from the current World Health Organization classification and the other used the morphological features of the terminal respiratory unit (TRU). The maximal standardized uptake value (SUVmax) on PET/CT and the glucose transporter type 1 (GLUT-1) expression of the tumors were measured and correlated to the histology of lung adenocarcinoma.
One hundred fifty-two patients with 153 primary lung adenocarcinomas were included. There was a significant difference in SUVmax among different histological subtypes. Namely, solid predominant adenocarcinomas had significantly higher SUVmax than those with other predominant histology (p < 0.001), and TRU-type adenocarcinomas had significantly lower SUVmax than non-TRU-type adenocarcinomas (p < 0.001). Consistently, GLUT-1 expression was higher in tumors with a solid growth pattern than those without (p < 0.001) and in tumors with non-TRU type than TRU type (p < 0.001).
The histological subtypes of lung adenocarcinomas differ in GLUT-1 expression and ¹⁸F-FDG uptake on the PET/CT scan, suggesting that histological subtyping not only has morphological but also biological implications.
先前的研究表明，肺鳞状细胞癌在正电子发射断层扫描（PET）上的¹⁸F-氟脱氧葡萄糖（FDG）摄取高于腺癌。我们假设肺腺癌的组织学亚型在¹⁸F-FDG 摄取方面也存在差异。
本研究纳入了 2007 年 4 月至 2009 年 12 月期间接受术前 PET/计算机断层扫描（CT）扫描并接受完全肺腺癌切除术的患者。由于 PET/CT 的空间分辨率有限，因此排除了小于 1cm 的肿瘤进行分析。使用两种独立的分类系统对腺癌的组织学亚型进行分类；一种是对现行的世界卫生组织分类进行修改，另一种则使用终末呼吸单位（TRU）的形态特征。测量了 PET/CT 上的最大标准化摄取值（SUVmax）和肿瘤的葡萄糖转运蛋白 1（GLUT-1）表达，并将其与肺腺癌的组织学相关联。
本研究纳入了 152 例患者的 153 例原发性肺腺癌。不同组织学亚型的 SUVmax 存在显著差异。具体而言，以实体为主型腺癌的 SUVmax 明显高于其他主要组织学类型（p < 0.001），而 TRU 型腺癌的 SUVmax 明显低于非 TRU 型腺癌（p < 0.001）。同样，具有实体生长模式的肿瘤的 GLUT-1 表达高于无实体生长模式的肿瘤（p < 0.001），而非 TRU 型肿瘤的 GLUT-1 表达高于 TRU 型肿瘤（p < 0.001）。
肺腺癌的组织学亚型在 GLUT-1 表达和 PET/CT 扫描上的¹⁸F-FDG 摄取方面存在差异，表明组织学分型不仅具有形态学意义，而且具有生物学意义。
