Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan;
Department of Gastroenterological Surgery, Kagawa University, Kagawa, Japan.
Anticancer Res. 2024 Aug;44(8):3321-3330. doi: 10.21873/anticanres.17151.
BACKGROUND/AIM: F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is reportedly associated with the malignant potential of cancer. This study aimed to evaluate the association between FDG accumulation and tumor metabolism in pancreatic ductal adenocarcinoma (PDAC).
A prognostic analysis of data from 131 patients with PDAC who underwent FDG-PET/CT before curative-intent pancreatic surgery was performed. Capillary electrophoresis-mass spectrometry (CE-MS) was used to analyze the metabolome of tumor and non-neoplastic pancreas from 80 patients. These patients were divided into two groups: low SUVmax group (SUVmax <6.09) and high SUVmax group (SUVmax ≥6.09).
Carbohydrate antigen 19-9 (CA19-9), maximum standardized uptake value (SUVmax) of PET, N stage, and postoperative chemotherapy were identified as significant prognostic factors by univariate analysis. SUVmax emerged as an independent prognostic factor for overall survival [hazard ratio (HR)=1.88, p<0.05] and disease-free survival (HR=2.01, p<0.05) in multivariate analysis. Metabolic analyses confirmed that 43 metabolites significantly differed depending on the accumulation of SUV in tumors. Metabolites involved in the removal of reactive oxygen species (e.g., hypotaurine, glutathione, Met), treatment resistance (UDP-N-acetylglucosamine), and proliferation (e.g., choline, leucine, isoleucine) were increased in the high SUVmax group.
FDG accumulation is an important independent prognostic factor reflecting tumor activity associated with metabolic changes in cancer cells.
背景/目的：正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）与癌症的恶性潜能有关。本研究旨在评估胰腺导管腺癌（PDAC）中 FDG 积聚与肿瘤代谢之间的关系。
对 131 例接受根治性胰腺手术前 FDG-PET/CT 的 PDAC 患者进行了数据预后分析。采用毛细管电泳-质谱（CE-MS）分析了 80 例患者肿瘤和非肿瘤胰腺的代谢组学。这些患者被分为两组：低 SUVmax 组（SUVmax<6.09）和高 SUVmax 组（SUVmax≥6.09）。
单因素分析确定了碳水化合物抗原 19-9（CA19-9）、PET 的最大标准化摄取值（SUVmax）、N 期和术后化疗是显著的预后因素。SUVmax 是总体生存（HR=1.88，p<0.05）和无病生存（HR=2.01，p<0.05）的独立预后因素。代谢分析证实，根据肿瘤 SUV 的积聚，有 43 种代谢物存在显著差异。参与清除活性氧的代谢物（如牛磺酸、谷胱甘肽、Met）、治疗耐药性（UDP-N-乙酰葡萄糖胺）和增殖（如胆碱、亮氨酸、异亮氨酸）在高 SUVmax 组中增加。
FDG 积聚是反映与癌细胞代谢变化相关的肿瘤活性的重要独立预后因素。
