Sun Yinwen, Sun Xiangfei, Xiong Ran, Li Chao, Zhou Yuning, Jiang Wenchao, Wang Hongshan, Gao Xiaodong
Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai 200032, China.
Department of General Surgery, Zhongshan Hospital Wusong Branch, Fudan University, Shanghai 200940, China.
Biomedicines. 2025 Feb 21;13(3):554. doi: 10.3390/biomedicines13030554.
This study aimed to investigate the clinical and prognostic significance of preoperative maximum standardized uptake value (SUVmax) and GLUT-1 expression in patients with advanced gastric cancer (AGC). Medical records of patients who were diagnosed with AGC between 2018 and 2020 at Zhongshan Hospital of Fudan University (Shanghai, China) were retrospectively analyzed. Finally, 182 patients were enrolled, and for each patient, SUVmax was calculated for the primary lesion on PET/CT prior to curative surgery. A total of 165 clinical tissue specimens were collected for immunohistochemical analysis of GLUT-1 expression. A total of 182 patients were divided into two groups based on their SUVmax values. The low SUVmax group comprised 92 patients. Patients with low SUVmax tended to be younger and included a higher proportion of women, with their primary tumors typically smaller or in earlier TNM stages. The median follow-up time was 52 months. The 1-, 3-, and 5-year progression-free survival (PFS) rates were 90.7%, 71.4%, and 67.0%, respectively. Among them, 33 patients experienced recurrence and metastasis, and 40 ultimately died. Log-rank analysis revealed that the low SUVmax group exhibited superior progression-free survival (PFS) and overall survival (OS). Multivariate analysis indicated that, for AGC without preoperative treatment, later stage (stage III) was independently correlated with a higher risk of recurrence (HR = 3.049; 95%CI = 1.076-8.639; = 0.036), while the low SUVmax group exhibited a reduced risk of recurrence and mortality compared with the high SUVmax group (HR = 0.565; 95%CI = 0.326-0.979; = 0.042). The clinicopathological characteristics of patients with AGC with different SUVmax values appeared significantly different. Tumor stage and SUVmax were found as independent factors affecting postoperative recurrence and death of patients with AGC.
本研究旨在探讨术前最大标准化摄取值（SUVmax）和葡萄糖转运蛋白1（GLUT-1）表达在晚期胃癌（AGC）患者中的临床及预后意义。回顾性分析了2018年至2020年期间在复旦大学附属中山医院（中国上海）被诊断为AGC的患者的病历。最终，纳入了182例患者，为每例患者在根治性手术前计算PET/CT上原发灶的SUVmax。共收集了165份临床组织标本用于GLUT-1表达的免疫组化分析。根据SUVmax值将182例患者分为两组。低SUVmax组包括92例患者。低SUVmax患者往往更年轻，女性比例更高，其原发肿瘤通常更小或处于更早的TNM分期。中位随访时间为52个月。1年、3年和5年无进展生存率（PFS）分别为90.7%、71.4%和67.0%。其中，33例患者出现复发和转移，40例最终死亡。对数秩分析显示，低SUVmax组的无进展生存期（PFS）和总生存期（OS）更优。多因素分析表明，对于未接受术前治疗的AGC患者，晚期（III期）与更高的复发风险独立相关（HR = 3.049；95%CI = 1.076 - 8.639；P = 0.036），而低SUVmax组与高SUVmax组相比，复发和死亡风险降低（HR = 0.565；95%CI = 0.326 - 0.979；P = 0.042）。不同SUVmax值的AGC患者的临床病理特征存在显著差异。肿瘤分期和SUVmax被发现是影响AGC患者术后复发和死亡的独立因素。
