Department of General Thoracic Surgery, Kawasaki Medical School, Kurashiki, Japan.
Ann Thorac Surg. 2012 Feb;93(2):398-403. doi: 10.1016/j.athoracsur.2011.10.033. Epub 2011 Dec 27.
Cyclooxygenase-2 (COX-2) is constitutively overexpressed in a variety of epithelial malignancies and is usually associated with a poor prognosis. Fluorodeoxyglucose positron emission tomography (FDG-PET) has become an important tool for the diagnosis and staging of non-small-cell lung cancer. The maximal standardized uptake values (SUVmax) of primary tumors on FDG-PET have been shown to be correlated with some clinicopathologic factors. In this study, we investigated the prediction of intratumoral COX-2 expression by FDG-PET in cases of lung adenocarcinoma.
We conducted a retrospective review of the data of 60 patients with lung adenocarcinoma measuring less than 3 cm in diameter. Immunohistochemical staining for COX-2 and other biological factors that might influence cancer progression was performed, and the correlations of the selective tumor marker expression with the SUVmax were evaluated.
A significant correlation was observed between the SUVmax and the expressions of COX-2, Ki-67, and vascular endothelial growth factor (VEGF). Multiple stepwise regression analysis revealed significant relationships between the SUVmax and the expression of COX-2 (p<0.001) and Ki-67 (p=0.016). Of the 2, COX-2 expression was the stronger determinant of the SUVmax, which increased in proportion to the score for COX-2 expression. The recurrence-free survival of patients with elevated COX-2 expression was significantly worse than that of patients not showing COX-2 expression.
The expression of COX-2 in primary tumors is as strongly correlated with a worse clinical outcome as is increased FDG uptake in cases of lung adenocarcinoma. These findings indicate that the SUVmax of primary tumors might reflect the biological malignant potential in lung adenocarcinomas.
环氧化酶-2（COX-2）在多种上皮恶性肿瘤中持续过表达，通常与预后不良相关。氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）已成为诊断和分期非小细胞肺癌的重要工具。FDG-PET 上原发肿瘤的最大标准化摄取值（SUVmax）已被证明与一些临床病理因素相关。在这项研究中，我们研究了 FDG-PET 预测肺腺癌肿瘤内 COX-2 表达的情况。
我们对 60 例直径小于 3cm 的肺腺癌患者的数据进行了回顾性分析。进行 COX-2 及其他可能影响癌症进展的生物学因素的免疫组织化学染色，并评估了这些选择性肿瘤标志物的表达与 SUVmax 的相关性。
SUVmax 与 COX-2、Ki-67 和血管内皮生长因子（VEGF）的表达呈显著相关。多步逐步回归分析显示，SUVmax 与 COX-2（p<0.001）和 Ki-67（p=0.016）的表达显著相关。在这两者中，SUVmax 与 COX-2 表达之间存在显著的关系（p<0.001），并且 COX-2 表达分数越高，SUVmax 值越高。COX-2 表达升高的患者无复发生存率明显差于 COX-2 表达阴性的患者。
在肺腺癌中，原发肿瘤 COX-2 的表达与 FDG 摄取增加一样，与更差的临床结局密切相关。这些发现表明，原发肿瘤的 SUVmax 可能反映了肺腺癌的生物学恶性潜能。
