Department of Pathology and Oncology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan; Department of Surgery, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan.
Department of Pathology and Oncology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan; Department of Pathology, National Hospital Organization, Okinawa National Hospital, Okinawa, Japan.
Lung Cancer. 2018 Sep;123:30-35. doi: 10.1016/j.lungcan.2018.06.004. Epub 2018 Jun 9.
Although positron emission tomography (PET) with 2-deoxy-2-[fluorine-18]fluoro-d-glucose integrated with computed tomography (CT), (F-FDG PET/CT), has recently improved the mediastinal nodal staging of non-small cell lung cancer (NSCLC), this method can show false negativity. We immunohistochemically investigated the expression of glucose transporters (GLUT-1, SGLT-1, and SGLT-2) in false negative and true positive mediastinal nodes via F-FDG PET/CT.
We investigated patients with clinically-diagnosed N0/pathological N2 diseases and patients with clinically-diagnosed N2/pathological N2 disease. The patients who were included in this study were evaluated using F-FDG PET/CT followed by surgical resection between January 2004 and December 2015. The expression of GLUT-1, SGLT-1, and SGLT-2 in the metastatic mediastinal lymph nodes, and clinicopathological variables such as primary tumor size, lymph node size, histological type, and SUV of the primary lesion, were compared between false negative nodes and true positive nodes.
The total number of PET false negative metastatic mediastinal lymph nodes was 22 in the 17 patients who were clinical N0/pathological N2, and the number of PET true positives was 15 in the 11 patients who were clinical N2/pathological N2. GLUT-1 expression was positive in five false negative nodes and 10 true positive nodes. SGLT-2 expression was positive in 12 false negative nodes and one true positive node, whereas both false negative and true positive nodes showed no SGLT-1 staining. Univariate analysis showed that the reduced expression of GLUT-1 (P = 0.015), and overexpression of SGLT-2 (P = 0.004) were the significant causative factors for false negative nodes. Multivariate analysis also showed that the reduced expression of GLUT-1 (P = 0.012) and overexpression of SGLT-2 (P = 0.006) were the significant causative factors for false negative nodes.
It suggests that the reduced expression of GLUT-1 and overexpression of SGLT-2 are associated with false-negative lymph node metastases in NSCLC.
尽管正电子发射断层扫描（PET）与 2-脱氧-2-[氟-18]氟代-d-葡萄糖结合计算机断层扫描（CT）（F-FDG PET/CT）最近提高了非小细胞肺癌（NSCLC）的纵隔淋巴结分期，但该方法可能显示假阴性。我们通过 F-FDG PET/CT 对假阴性和真阳性纵隔淋巴结中的葡萄糖转运蛋白（GLUT-1、SGLT-1 和 SGLT-2）表达进行了免疫组织化学研究。
我们研究了临床诊断为 N0/病理 N2 疾病和临床诊断为 N2/病理 N2 疾病的患者。本研究纳入的患者于 2004 年 1 月至 2015 年 12 月期间通过 F-FDG PET/CT 评估后进行手术切除。比较了假阴性淋巴结和真阳性淋巴结中转移性纵隔淋巴结的 GLUT-1、SGLT-1 和 SGLT-2 表达以及原发性肿瘤大小、淋巴结大小、组织学类型和原发性病变 SUV 等临床病理变量。
17 例临床 N0/病理 N2 患者中 PET 假阴性转移性纵隔淋巴结总数为 22 个，11 例临床 N2/病理 N2 患者中 PET 真阳性数为 15 个。假阴性淋巴结中有 5 个和真阳性淋巴结中有 10 个 GLUT-1 表达阳性。SGLT-2 表达阳性 12 个假阴性淋巴结和 1 个真阳性淋巴结，而假阴性和真阳性淋巴结均无 SGLT-1 染色。单因素分析显示，GLUT-1 表达降低（P=0.015）和 SGLT-2 过表达（P=0.004）是假阴性淋巴结的显著致病因素。多因素分析还显示，GLUT-1 表达降低（P=0.012）和 SGLT-2 过表达（P=0.006）是假阴性淋巴结的显著致病因素。
这表明 GLUT-1 表达降低和 SGLT-2 过表达与 NSCLC 中假阴性淋巴结转移有关。
