晚期胃癌中 F-氟脱氧葡萄糖摄取与组织病理学亚型和肿瘤间质体积相关。
F-fluorodeoxyglucose uptake in advanced gastric cancer correlates with histopathological subtypes and volume of tumor stroma.
机构信息
Department of Radiology, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga 520-2192, Japan.
Department of Radiology, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga 520-2192, Japan.
出版信息
Eur J Radiol. 2021 Dec;145:110048. doi: 10.1016/j.ejrad.2021.110048. Epub 2021 Nov 16.
PURPOSE
The aim of this study was to investigate the correlation between preoperative F-fluorodeoxyglucose (FDG) uptake and histological subtypes, amount of tumor stroma in advanced gastric cancer (GC), and clinical outcomes.
METHODS
We evaluated 56 patients (male/female, 42:14; mean age, 69 years) with advanced GC who underwent surgical resection at our institution and positron emission tomography-computed tomography with 18F-FDG prior to surgery. We used the maximum standardized uptake value (SUVmax) of the tumor and the tumor-to-liver ratio (TLR) of the SUVmax for the analysis. The SUVmax and TLR correlated with histological subtypes, immunohistochemistry (IHC) for CD34, and recurrence-free survival (RFS). Tumor stroma in GC was evaluated by CD34 expression. GCs were classified according to the Lauren and World Health Organization (WHO) classifications.
RESULTS
The average FDG uptakes (SUVmax) were 4.17% and 14.04% in diffuse and intestinal type GCs, respectively, according to the Lauren classification, and 4.17%, 13.87%, 7.70%, 9.71%, and 19.45% in the poorly cohesive, tubular, mucinous, and papillary adenocarcinomas, respectively, according to the WHO classification. The FDG uptake in diffuse type was significantly lower than that in the intestinal type (p = 0.000). The SUVmax and TLR of the CD34(+) group (mean SUVmax, 5.50; TLR, 1.56) were significantly lower than those of the CD34(-) group (mean SUVmax, 14.09; TLR, 4.09). RFS was not associated with TLR or CD34 expression.
CONCLUSION
GC, which has abundant tumor stroma characterized by high CD34 expression on IHC, shows low FDG uptake.
目的
本研究旨在探讨术前 F-氟代脱氧葡萄糖（FDG）摄取与晚期胃癌（GC）的组织学亚型、肿瘤间质量以及临床结局之间的相关性。
方法
我们评估了在我院接受手术切除并在手术前进行正电子发射断层扫描-计算机断层扫描（PET-CT）与 18F-FDG 的 56 例晚期 GC 患者（男/女，42:14；平均年龄，69 岁）。我们使用肿瘤的最大标准化摄取值（SUVmax）和 SUVmax 的肿瘤与肝脏比值（TLR）进行分析。SUVmax 和 TLR 与组织学亚型、CD34 的免疫组化（IHC）以及无复发生存率（RFS）相关。GC 中的肿瘤间质通过 CD34 表达进行评估。GC 根据 Lauren 和世界卫生组织（WHO）分类进行分类。
结果
根据 Lauren 分类，弥漫型和肠型 GC 的 FDG 摄取（SUVmax）平均值分别为 4.17%和 14.04%，根据 WHO 分类，分别为低黏附型、管状型、黏液型和乳头状腺癌的 4.17%、13.87%、7.70%、9.71%和 19.45%。弥漫型的 FDG 摄取明显低于肠型（p=0.000）。CD34（+）组的 SUVmax 和 TLR（平均 SUVmax，5.50；TLR，1.56）明显低于 CD34（-）组（平均 SUVmax，14.09；TLR，4.09）。RFS 与 TLR 或 CD34 表达无关。
结论
在 IHC 上具有丰富肿瘤间质特征的 GC，其 FDG 摄取量较低，这些肿瘤间质的 CD34 表达较高。
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