氟-18-氟代甲氧异丁基异腈正电子发射断层扫描摄取与口腔鳞状细胞癌中缺氧诱导因子-1α表达相关。
18F-fluoromisonidazole PET uptake is correlated with hypoxia-inducible factor-1α expression in oral squamous cell carcinoma.
机构信息
Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan.
出版信息
J Nucl Med. 2013 Jul;54(7):1060-5. doi: 10.2967/jnumed.112.114355. Epub 2013 May 22.
UNLABELLED
Hypoxia is a common feature of cancer and a prognostic factor for many types of cancer. (18)F-fluoromisonidazole ((18)F-FMISO) PET can detect tumor hypoxia noninvasively. Hypoxia-inducible factor-1 (HIF-1) is a key player in the transcriptional response to low oxygen tension in many types of cancer. Its activity is mainly dependent on the stability and modification of HIF-1α, which is a composition of HIF-1. However, it is unclear whether (18)F-FMISO PET can identify HIF-1α expression in oral squamous cell carcinoma (OSCC). The present study was performed to elucidate the correlation between (18)F-FMISO PET findings and HIF-1α expression in OSCC.
METHODS
Twenty-three patients (age range, 42-84 y; 15 men, 8 women) with OSCC were enrolled in this study. The T-stages of cancer were T1 in 1 patient, T2 in 9, T3 in 2, and T4a in 11. The N-stages were N0 in 13 patients, N1 in 5, and N2 in 5. Each patient underwent (18)F-FMISO and (18)F-FDG PET before surgery, and the maximum standardized uptake value (SUV max) of both PET studies was measured. HIF-1α expression in the operation materials was evaluated by immunohistochemical staining. The SUV max of both PET studies and HIF-1α findings were compared statistically.
RESULTS
(18)F-FMISO PET detected uptake in the primary site in 14 of the 23 patients (61%). The median SUV max of (18)F-FMISO and (18)F-FDG PET in the primary site was 1.83 (range, 0.8-2.7) and 16.5 (range, 1.0-32.3), respectively. There was a weak significant correlation between (18)F-FMISO and (18)F-FDG PET SUV max (P = 0.02, r = 0.48). HIF-1α expression was clearly detected in 11 of the 23 patients (48%). The (18)F-FMISO PET SUV max was significantly higher in the HIF-1α-positive cases than in the HIF-1α-negative cases (median, 2.1; range, 1.5-2.4, vs. median, 1.6; range, 0.8-2.0, respectively) (P = 0.002). However, there were no significant correlations between (18)F-FDG PET SUV max and HIF-1α expression (median, 21.8; range, 7.7-29.1 vs. 1.0-32.2) (P = 0.06).
CONCLUSION
(18)F-FMISO uptake in the primary site of OSCC indicates a hypoxic environment with HIF-1α expression.
目的
阐明口腔鳞状细胞癌（OSCC）中（18）F-氟代单唾液酸神经节苷脂（（18）F-FMISO）正电子发射断层扫描（PET）摄取与缺氧诱导因子-1α（HIF-1α）表达之间的相关性。
方法
本研究纳入了 23 例 OSCC 患者（年龄 42-84 岁；男 15 例，女 8 例）。癌症的 T 分期为 T1 期 1 例，T2 期 9 例，T3 期 2 例，T4a 期 11 例。N 分期为 N0 期 13 例，N1 期 5 例，N2 期 5 例。每位患者均在术前接受（18）F-FMISO 和（18）F-FDG PET 检查，并测量了两种 PET 研究的最大标准化摄取值（SUVmax）。采用免疫组织化学染色法评估手术标本中的 HIF-1α 表达情况。对两种 PET 研究的 SUVmax 和 HIF-1α 结果进行统计学比较。
结果
（18）F-FMISO PET 在 23 例患者中的 14 例（61%）原发性肿瘤部位检测到摄取。原发性肿瘤部位（18）F-FMISO 和（18）F-FDG PET 的 SUVmax 中位数分别为 1.83（范围，0.8-2.7）和 16.5（范围，1.0-32.3）。（18）F-FMISO 和（18）F-FDG PET SUVmax 之间存在弱显著相关性（P=0.02，r=0.48）。在 23 例患者中有 11 例（48%）明确检测到 HIF-1α 表达。HIF-1α 阳性病例的（18）F-FMISO PET SUVmax 明显高于 HIF-1α 阴性病例（中位数分别为 2.1（范围，1.5-2.4）和 1.6（范围，0.8-2.0）（P=0.002）。然而，（18）F-FDG PET SUVmax 与 HIF-1α 表达之间无显著相关性（中位数分别为 21.8（范围，7.7-29.1）和 1.0-32.2）（P=0.06）。
结论
OSCC 原发灶的（18）F-FMISO 摄取表明存在缺氧环境，伴有 HIF-1α 表达。
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