Hirashita Teijiro, Hirashita Yuka, Iwashita Yukio, Endo Yuichi, Kiyonaga Maki, Matsumoto Shunro, Hijiya Naoki, Moriyama Masatsugu, Murakami Kazunari, Inomata Masafumi
Department of Gastroenterological and Pediatric Surgery Faculty of Medicine Oita University Yufu Japan.
Gastroenterology Faculty of Medicine Oita University Yufu Japan.
Ann Gastroenterol Surg. 2020 Jun 24;4(5):571-579. doi: 10.1002/ags3.12367. eCollection 2020 Sep.
Glucose metabolism of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas is unclear. S6 ribosomal protein (S6) phosphorylation is involved not only in controlling cell growth but also in glucose metabolism in cancer. The aim of this study was to investigate the role of S6 phosphorylation and the significance of glucose metabolic changes in IPMN.
Records of 39 patients who underwent preoperative FDG-PET and curative resection were enrolled in this study. S6 phosphorylation and GLUT1 expression were evaluated immunohistochemically in these patients. The effect of S6 phosphorylation on glucose uptake was examined in cancer cell lines. To examine the change of glucose metabolism in IPMN clinically, the relation between clinical factors including FDG-PET and malignancy of IPMN was investigated.
S6 phosphorylation and GLUT1 expression were significantly higher in carcinoma than in normal cells or adenoma. Cell lines with high level of S6 phosphorylation showed high glucose uptake, and inhibition of S6 phosphorylation reduced glucose uptake. In clinical examination, FDG-PET was the independent factor related to the diagnosis of adenoma or carcinoma (odds ratio = 20.0, 95% confidence interval = 1.837-539.9, = .012). FDG-PET detected carcinoma with a sensitivity of 81.8%, specificity of 96.4%, and accuracy of 92.3%.
S6 phosphorylation was associated with glucose uptake and malignancy of IPMN. Moreover, glucose uptake increased in malignant cells of IPMN, and FDG-PET is useful for detecting malignancy of IPMN.
胰腺导管内乳头状黏液性肿瘤（IPMNs）的葡萄糖代谢尚不清楚。S6核糖体蛋白（S6）磷酸化不仅参与控制细胞生长，还参与癌症中的葡萄糖代谢。本研究的目的是探讨S6磷酸化的作用以及IPMN中葡萄糖代谢变化的意义。
本研究纳入了39例行术前FDG-PET及根治性切除术患者的记录。对这些患者进行免疫组织化学评估S6磷酸化和GLUT1表达。在癌细胞系中检测S6磷酸化对葡萄糖摄取的影响。为了临床上检测IPMN中葡萄糖代谢的变化，研究了包括FDG-PET在内的临床因素与IPMN恶性程度之间的关系。
癌组织中S6磷酸化和GLUT1表达明显高于正常细胞或腺瘤。S6磷酸化水平高的细胞系显示出高葡萄糖摄取，抑制S6磷酸化可降低葡萄糖摄取。在临床检查中，FDG-PET是与腺瘤或癌诊断相关的独立因素（比值比=20.0，95%置信区间=1.837-539.9，P=.012）。FDG-PET检测癌的灵敏度为81.8%，特异度为96.4%，准确度为92.3%。
S6磷酸化与IPMN的葡萄糖摄取及恶性程度相关。此外，IPMN恶性细胞中的葡萄糖摄取增加，FDG-PET有助于检测IPMN的恶性程度。
