Schreurs L M A, Smit J K, Pavlov K, Pultrum B B, Pruim J, Groen H, Hollema H, Plukker John Th M
Department of Surgical Oncology/Gastrointestinal Surgery, University of Groningen/University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
Ann Surg Oncol. 2014 Nov;21(12):3751-7. doi: 10.1245/s10434-014-3848-6. Epub 2014 Jun 18.
To analyze the association between pretreatment 18-F-fluoro-deoxyglucose (FDG) uptake and characteristics of aggressive tumor biology in predicting outcome in esophageal cancer (EC).
Tumor FDG-uptake was measured by maximum standardized uptake values (SUVmax) in 47 patients undergoing esophagectomy with curative intent. ROC analyses were used to predict an optimal SUVmax cutoff for survival. Expression of hexokinase-II (HK-II), glucose transporter I (GLUT-I), hypoxia inducible factor-1α (HIF-Iα), vascular endothelial growth factor-C (VEGF-C), p53, and proliferative activity (Ki-67) were correlated with SUVmax values and clinicopathological characteristics.
A SUVmax > 3.67 predicted a significantly lower disease-free survival (DFS) and distant recurrence-free survival (p = 0.022 and p = 0.005). High HK-II expression was correlated with reduced SUVmax values (p = 0.002) and was significantly higher in esophageal adenocarcinoma compared with squamous cell carcinoma (p = 0.005). Preoperative high FDG uptake in primary tumors was associated with nodal metastases (pN1; Spearman correlation 0.39, p = 0.01). We found no positive correlation between SUVmax and GLUT-1, HK-1, HIF-Iα 1, VEGF-C, p53, and Ki-67 expression.
High preoperative FDG-uptake strongly predicts poor survival outcome and is associated with lymph node metastases in EC patients. HK-II expression was related to SUVmax and DFS.
分析术前18-F-氟脱氧葡萄糖（FDG）摄取与侵袭性肿瘤生物学特征之间的关联，以预测食管癌（EC）的预后。
对47例接受根治性食管切除术的患者，通过最大标准化摄取值（SUVmax）测量肿瘤FDG摄取情况。采用ROC分析来预测生存的最佳SUVmax临界值。己糖激酶-II（HK-II）、葡萄糖转运蛋白I（GLUT-I）、缺氧诱导因子-1α（HIF-Iα）、血管内皮生长因子-C（VEGF-C）、p53的表达以及增殖活性（Ki-67）与SUVmax值和临床病理特征相关。
SUVmax > 3.67预测无病生存期（DFS）和远处无复发生存期显著降低（p = 0.022和p = 0.005）。HK-II高表达与SUVmax值降低相关（p = 0.002），且在食管腺癌中显著高于鳞状细胞癌（p = 0.005）。原发性肿瘤术前FDG摄取高与淋巴结转移相关（pN1；Spearman相关性0.39，p = 0.01）。我们发现SUVmax与GLUT-1、HK-1、HIF-Iα 1、VEGF-C、p53和Ki-67表达之间无正相关。
术前FDG摄取高强烈预测EC患者生存预后不良，且与淋巴结转移相关。HK-II表达与SUVmax和DFS相关。
