Lee Jai Hyuen, Lee Won Ae, Park Seok Gun, Park Dong Kook, Namgung Hwan
Department of Nuclear Medicine, Dankook University College of Medicine, Dongnam-ku, Anseo-dong, Cheonan, 330-715 Republic of Korea.
Department of Pathology, Dankook University College of Medicine, Cheonan, Korea.
Nucl Med Mol Imaging. 2012 Mar;46(1):48-56. doi: 10.1007/s13139-011-0120-x. Epub 2012 Jan 3.
The clinical availability of 2-deoxy-2-[18F] fluoro-D-glucose (FDG) dual-time point positron emission tomography/computerized tomography (DTPP) has been investigated in diverse oncologic fields. The aim of this preliminary study was to evaluate the relationship between various immunohistopathologic markers reflecting disease progression of colorectal cancer and parameters extracted from FDG DTPP in colorectal cancer patients.
Forty-seven patients with histologically confirmed colorectal cancer were analyzed in this preliminary study. FDG DTPP consisted of an early scan 1 h after FDG injection and a delayed scan 1.5 h after the early scan. Based on an analysis of FDG DTPP, we estimated the maximum standardized uptake value (SUV) of tumors on the early and delayed scans (SUVearly and SUVdelayed, respectively). The retention index (RI) was calculated as follows: (SUVdelayed - SUVearly) × 100/ SUVearly. The clinicopathological findings (size and T and N stages) and immunohistochemical factors [glucose transporter 1 (GLUT-1), hexokinase 2 (HK-2), p53, P504S, and β-catenin] were analyzed by visual analysis.
The RIs calculated from the SUVs ranged from -1.8 to 73.4 (31.8 ± 15.5). The RIs were significantly higher in patients with high T stages (T3 and T4) than with low T stages (T1 and T2; p < 0.05). Among the immunohistochemical analytic markers, GLUT-1 had the highest positive staining rate (93.6%) compared to other markers. Based on univariable analysis, it was shown that the RI of high-level GLUT-1 expression was significantly higher than low-level GLUT-1 expression (p = 0.01), and the RI of high-level p53 expression was slightly higher than low-level p53 expression (p = 0.08). Multivariate analysis to investigate a link between RI and clinicopathologic parameters of colorectal carcinoma showed that GLUT-1, p53, and T staging were independently connected with increased RIs (p < 0.05, total) using backward selection methods. There was no significant statistical relationship between SUVearly and SUVdelayed and clinicopathologic parameters in this study.
The RIs obtained from preoperative colorectal cancers had a significant relationship to tumor size, T staging, GLUT-1, and p53, in contrast to SUVearly or SUVdelayed. Compared with previous reports, our results showed that RI can better predict GLUT-1 expression than HK-2 and other immunohistochemical markers. This study demonstrated that the RI might have the potential to be applied as a prognostic marker in preoperative colorectal cancer.
在不同肿瘤领域对2-脱氧-2-[¹⁸F]氟-D-葡萄糖（FDG）双时相正电子发射断层扫描/计算机断层扫描（DTPP）的临床可用性进行了研究。这项初步研究的目的是评估反映结直肠癌疾病进展的各种免疫组织病理学标志物与从结直肠癌患者的FDG DTPP中提取的参数之间的关系。
在这项初步研究中分析了47例经组织学确诊的结直肠癌患者。FDG DTPP包括FDG注射后1小时的早期扫描和早期扫描后1.5小时的延迟扫描。基于对FDG DTPP的分析，我们估计了早期和延迟扫描时肿瘤的最大标准化摄取值（SUV）（分别为SUVearly和SUVdelayed）。保留指数（RI）计算如下：（SUVdelayed - SUVearly）×100 / SUVearly。通过视觉分析对临床病理结果（大小以及T和N分期）和免疫组化因素[葡萄糖转运蛋白1（GLUT-1）、己糖激酶2（HK-2）、p53、P504S和β-连环蛋白]进行分析。
根据SUV计算的RI范围为-1.8至73.4（31.8±15.5）。高T分期（T3和T4）患者的RI显著高于低T分期（T1和T2）患者（p <0.05）。在免疫组化分析标志物中，与其他标志物相比，GLUT-1的阳性染色率最高（93.6%）。基于单变量分析，结果显示高水平GLUT-1表达的RI显著高于低水平GLUT-1表达（p = 0.01），高水平p53表达的RI略高于低水平p53表达（p = 0.08）。采用向后选择法进行多变量分析以研究RI与结直肠癌临床病理参数之间的联系，结果显示GLUT-1、p53和T分期与RI升高独立相关（p <0.05，总体）。在本研究中，SUVearly和SUVdelayed与临床病理参数之间无显著统计学关系。
与SUVearly或SUVdelayed相比，术前结直肠癌获得的RI与肿瘤大小、T分期、GLUT-1和p53具有显著关系。与先前的报告相比，我们的结果显示RI比HK-2和其他免疫组化标志物能更好地预测GLUT-1表达。这项研究表明RI可能有潜力作为术前结直肠癌的预后标志物应用。
