术前高最大标准化摄取值联合葡萄糖转运蛋白1预示胰腺癌预后不良。

Preoperative High Maximum Standardized Uptake Value in Association with Glucose Transporter 1 Predicts Poor Prognosis in Pancreatic Cancer.

作者信息

Chikamoto Akira, Inoue Risa, Komohara Yoshiaki, Sakamaki Kentaro, Hashimoto Daisuke, Shiraishi Shinya, Takamori Hiroshi, Yamashita Yo-Ichi, Yoshida Naoya, Yamanaka Takeharu, Yamashita Yasuyuki, Baba Hideo

机构信息

Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.

Department of Cell Pathology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.

出版信息

Ann Surg Oncol. 2017 Jul;24(7):2040-2046. doi: 10.1245/s10434-017-5799-1. Epub 2017 Feb 8.

DOI:10.1245/s10434-017-5799-1

PMID:28180987

Abstract

BACKGROUND

The diagnosis of malignant diseases worldwide has been determined using F-fluorodeoxyglucose positron emission tomography (FDG-PET). Glucose transporter type 1 (Glut-1) is a key protein associated with the accumulation of FDG in cancer cells. This study evaluated the relationship between Glut-1 expression and FDG accumulation to determine the usefulness of FDG-PET for prediction of long-term outcomes of pancreatic cancer.

METHODS

The expression of Glut-1 was immunohistochemically examined in 138 surgically resected pancreatic cancer specimens. The Glut-1-positive and Glut-1-negative groups were analyzed with respect to their clinicopathologic characteristics and prognosis. Before surgery, 93 patients underwent FDG-PET and measurement of the corrected maximum standardized uptake value (cSUVmax). The relationship between Glut-1 expression and cSUVmax were examined, and prognostic factors were identified using uni- and multivariate analyses.

RESULTS

Glut-1 was positive in 69 patients (50%). The median relapse-free and overall survival times were significantly shorter in the Glut-1-positive group (11 vs. 22 months, respectively) than in the Glut-1-negative group (23 vs. 42 months, respectively). The cSUVmax was significantly associated with long-term survival. The relapse-free and overall survival rates were significantly poorer in the high-cSUVmax group than in the low-cSUVmax group. Glut-1 expression was associated with cSUVmax accumulation. In the multivariate Cox regression analysis using forward stepwise selection, male gender, positive lymph node metastases, high CA19-9, and high cSUVmax were identified as independent prognostic factors for pancreatic cancer.

CONCLUSION

A significant relationship exists between high preoperative cSUVmax and Glut-1 expression. High cSUVmax is one of the prognostic factors for overall survival after resection of pancreatic cancer.

摘要

背景

全球范围内恶性疾病的诊断已采用F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）。1型葡萄糖转运蛋白（Glut-1）是与癌细胞中FDG聚集相关的关键蛋白。本研究评估了Glut-1表达与FDG聚集之间的关系，以确定FDG-PET对预测胰腺癌长期预后的有用性。

方法

对138例手术切除的胰腺癌标本进行免疫组织化学检测Glut-1的表达。分析Glut-1阳性和Glut-1阴性组的临床病理特征和预后。术前，93例患者接受了FDG-PET检查并测量校正后的最大标准化摄取值（cSUVmax）。检查Glut-1表达与cSUVmax之间的关系，并使用单因素和多因素分析确定预后因素。

结果

69例患者（50%）Glut-1呈阳性。Glut-1阳性组的无复发生存期和总生存期的中位数（分别为11个月和22个月）明显短于Glut-1阴性组（分别为23个月和42个月）。cSUVmax与长期生存显著相关。高cSUVmax组的无复发生存率和总生存率明显低于低cSUVmax组。Glut-1表达与cSUVmax聚集相关。在采用向前逐步选择的多因素Cox回归分析中，男性、阳性淋巴结转移、高CA19-9和高cSUVmax被确定为胰腺癌的独立预后因素。