Hunt Ben M, Horton Matthew P, Vallières Eric
Swedish Medical Center and Cancer Institute, Seattle, WA, USA.
Eur J Cardiothorac Surg. 2014 Mar;45(3):527-30. doi: 10.1093/ejcts/ezt436. Epub 2013 Sep 18.
Bronchogenic carcinoid tumours are widely cited as non-fluorodeoxyglucose (FDG) avid. However, three case reports of FDG-avid bronchogenic carcinoid tumours have been published, leading to speculation as to which clinicopathological factors may be associated with increased activity on FDG-positron emission tomography. We reviewed a series of cases from our institution and compared them with the available reports in the literature, to attempt to identify the factors associated with FDG avidity in bronchogenic carcinoids.
We performed a single-institution retrospective review.
One patient was identified at our institution who had a typical carcinoid tumour with a standardized uptake value (SUV) of 26, oncocytic features on histology and positive staining for glucose transporter 1 (GLUT1). Three additional patients were identified in the literature with typical bronchogenic carcinoids with SUVs of 39, 38 and 33. Two of these tumours stained positive for GLUT1, and the remaining patient was not tested. Two of these patients had oncocytic features on histology, and results on the remaining patient are not reported. Additionally, 4 patients at our institution were identified with bronchogenic carcinoids with average SUV of 2.6. All were GLUT1 negative, and none had oncocytic features. In the reported literature, excluding the four most FDG-avid tumours described above, atypical carcinoids had a higher mean SUV than typical carcinoids (5.7 vs 3.4, P = 0.02), but size was not correlated with SUV (r = 0.7, P = 0.3).
FDG uptake is commonly associated with worse prognosis in malignancy; however, bronchogenic carcinoids, particularly oncocytic typical carcinoids, are a possible source of extremely high SUVs on FDG-PET.
支气管类癌肿瘤被广泛认为是非氟脱氧葡萄糖（FDG）摄取性的。然而，已有3例FDG摄取性支气管类癌肿瘤的病例报告发表，这引发了关于哪些临床病理因素可能与FDG正电子发射断层扫描活性增加相关的猜测。我们回顾了本院的一系列病例，并与文献中的现有报告进行比较，试图确定支气管类癌中与FDG摄取相关的因素。
我们进行了单机构回顾性研究。
本院确诊1例典型类癌肿瘤患者，其标准化摄取值（SUV）为26，组织学上具有嗜酸性细胞特征，葡萄糖转运蛋白1（GLUT1）染色阳性。文献中另外3例确诊为典型支气管类癌患者，其SUV分别为39、38和33。其中2例肿瘤GLUT1染色阳性，其余1例未检测。这些患者中有2例组织学上具有嗜酸性细胞特征，其余1例患者的结果未报告。此外，本院还确诊4例支气管类癌患者，平均SUV为2.6。所有患者GLUT1均为阴性，且均无嗜酸性细胞特征。在已发表的文献中，除上述4例FDG摄取最高的肿瘤外，非典型类癌的平均SUV高于典型类癌（5.7对3.4，P = 0.02），但肿瘤大小与SUV无相关性（r = 0.7，P = 0.3）。
在恶性肿瘤中，FDG摄取通常与预后较差相关；然而，支气管类癌，尤其是嗜酸性细胞典型类癌，可能是FDG-PET上SUV极高的一个来源。
