Kim Tae Hyun, Kwak Yoonjin, Song Changhoon, Lee Hye Seung, Kim Duck-Woo, Oh Heung-Kwon, Kim Jin Won, Lee Keun-Wook, Kang Sung-Bum, Kim Jae-Sung
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Front Oncol. 2023 Mar 9;13:1094480. doi: 10.3389/fonc.2023.1094480. eCollection 2023.
Glucose transporter-1 (GLUT-1) has been studied as a possible predictor for survival outcomes in locally advanced rectal cancer (LARC).
We aimed to investigate the prognostic role of GLUT-1 in LARC using the data of 208 patients with clinical T3-4 stage and/or node-positive rectal adenocarcinoma, all of whom underwent neoadjuvant chemoradiotherapy (CRT) and subsequent total mesorectal excision (TME). Both pre-CRT and post-CRT specimens were immunohistologically stained for GLUT-1. Patients were classified into GLUT-1-positive and GLUT-1-negative groups and distant metastasis-free survival (DMFS) and overall survival (OS) was analyzed and compared.
At a median follow-up of 74 months, post-CRT GLUT-1 status showed a significant correlation with worse DMFS (p=0.027, HR 2.26) and OS (p=0.030, HR 2.30). When patients were classified into 4 groups according to yp stage II/III status and post-CRT GLUT-1 positivity [yp stage II & GLUT-1 (-), yp stage II & GLUT-1 (+), yp stage III & GLUT-1 (-), yp stage III & GLUT-1 (+)], the 5-year DMFS rates were 92.3%, 63.9%, 65.4%, and 46.5%, respectively (p=0.013). GLUT-1 (-) groups showed markedly better outcomes for both yp stage II and III patients compared to GLUT-1 (+) groups. A similar tendency was observed for OS.
In conclusion, post-CRT GLUT-1 may serve as a prognostic marker in LARC.
葡萄糖转运蛋白1（GLUT-1）已被作为局部晚期直肠癌（LARC）生存结局的一种可能预测指标进行研究。
我们旨在利用208例临床T3-4期和/或淋巴结阳性直肠腺癌患者的数据，研究GLUT-1在LARC中的预后作用，所有患者均接受了新辅助放化疗（CRT）及后续的全直肠系膜切除术（TME）。CRT前和CRT后的标本均进行了GLUT-1免疫组织化学染色。患者被分为GLUT-1阳性组和GLUT-1阴性组，并对无远处转移生存期（DMFS）和总生存期（OS）进行分析和比较。
在中位随访74个月时，CRT后GLUT-1状态与较差的DMFS（p=0.027，HR 2.26）和OS（p=0.030，HR 2.30）显著相关。当根据yp分期II/III状态和CRT后GLUT-1阳性情况将患者分为4组[yp分期II & GLUT-1（-），yp分期II & GLUT-1（+），yp分期III & GLUT-1（-），yp分期III & GLUT-1（+）]时，5年DMFS率分别为92.3%、63.9%、65.4%和46.5%（p=0.013）。与GLUT-1（+）组相比，GLUT-1（-）组在yp分期II和III患者中均显示出明显更好的结局。OS也观察到类似趋势。
总之，CRT后GLUT-1可能作为LARC的预后标志物。
