Meng Xiaoyan, Sun Jingjing, Xu Feng, Liu Zhonglong, He Yue
Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
College of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China.
Front Oncol. 2023 May 3;13:1156527. doi: 10.3389/fonc.2023.1156527. eCollection 2023.
Lymph node metastasis frequently occurs in head and neck squamous cell carcinoma (HNSCC) patients, and [F] fluorodeoxyglucose positron emission tomography with computed tomography (FDG-PET/CT) examination for lymph node metastasis could result in false negativity and delay following treatment. However, the mechanism and resolution for FDG-PET/CT false negatives remain unclear. Our study was aim to found biomarkers for false negativity and true positivity from a metabolic perspective.
Ninety-two patients diagnosed with HNSCC who underwent preoperative FDG-PET/CT and subsequent surgery in our institution were reviewed. Immunohistochemistry (IHC) examinations of glucose metabolism (GLUT1 and GLUT5), amino acid metabolism4 (GLS and SLC1A5), and lipid metabolism (CPT1A and CD36) markers were conducted on their primary lesion and lymph node sections.
We identified specific metabolic patterns of the false-negative group. Significantly, CD36 IHC score of primary lesions was higher in false-negative group than true-positive group. Moreover, we validated pro-invasive biological effects of CD36 by bioinformatics analysis as well as experiments. Conclusion: IHC examination of CD36 expression, which is a lipid metabolism marker, in primary lesions could distinguish HNSCC patients' lymph nodes false negatives in FDG-PET/CT.
淋巴结转移在头颈部鳞状细胞癌（HNSCC）患者中经常发生，而采用[F]氟脱氧葡萄糖正电子发射断层扫描与计算机断层扫描（FDG-PET/CT）检查淋巴结转移可能会出现假阴性并延误后续治疗。然而，FDG-PET/CT假阴性的机制和解决方法仍不清楚。我们的研究旨在从代谢角度寻找假阴性和真阳性的生物标志物。
回顾了92例在本机构接受术前FDG-PET/CT及后续手术的HNSCC患者。对其原发灶和淋巴结切片进行葡萄糖代谢（GLUT1和GLUT5）、氨基酸代谢（GLS和SLC1A5）以及脂质代谢（CPT1A和CD36）标志物的免疫组织化学（IHC）检查。
我们确定了假阴性组的特定代谢模式。值得注意的是，假阴性组原发灶的CD36 IHC评分高于真阳性组。此外，我们通过生物信息学分析以及实验验证了CD36的促侵袭生物学效应。结论：检测原发灶中作为脂质代谢标志物的CD36表达的IHC检查可区分HNSCC患者在FDG-PET/CT检查中的淋巴结假阴性情况。
