Higashi T, Tamaki N, Honda T, Torizuka T, Kimura T, Inokuma T, Ohshio G, Hosotani R, Imamura M, Konishi J
Department of Nuclear Medicine, Kyoto University Faculty of Medicine, Japan.
J Nucl Med. 1997 Sep;38(9):1337-44.
Although overexpression of GLUT-1 glucose transporter has already been reported in human cancers, the mechanism of glucose entry into pancreatic cancers remains unknown. To evaluate the relationship between GLUT glucose transporters and FDG uptake, FDG-PET was performed in 34 preoperative patients (mean age, 60.9 yr) with suspected pancreatic tumors, including 28 malignant and 6 benign tumors.
FDG uptake at 50 min after injection of 185 MBq of [18F]FDG with >5 hr of fasting was semiquantitatively analyzed as standardized uptake values (SUVs). The GLUT expression was studied by immunohistochemistry of paraffin sections from these tumors after operation using anti-GLUT-1, -2, -3, -4 and -5 antibodies to obtain immunohistochemical grading ("strong," "weak" and "negative") by three experienced physicians.
Of 26 malignant tumors proved by histological examination, 23 (88%) tumors were positive for the expression of GLUT-1 glucose transporter, and 17 (61%) showed strong expression. On the other hand, 13 (46%), 0 (0%), 9 (36%) and 13 (46%) malignant tumors were positive for the expression of GLUT-2, -3, -4 and -5 glucose transporters, respectively. Three of six benign tumors showed strong GLUT-1 expression. Concerning GLUT-2, -3, -4 and -5, only one benign tumor showed positive GLUT-5 expression. Thus, GLUT-1 showed relatively high sensitivity but low specificity (50%) for detecting malignant tumors, whereas GLUT-2, -3, -4 and -5 had lower sensitivities but higher specificities. Correlations between SUVs and grading of GLUT immunoreactivity were significant in GLUT-1 (strong, 4.49 +/- 2.95; weak, 3.42 +/- 1.21; negative, 2.52 +/- 0.84) (p < 0.05) but not in the remaining four GLUT transporters.
These data indicate that GLUT-1 has a significant role in the malignant glucose metabolism and may contribute to the increased uptake of FDG in PET imaging in patients with pancreatic tumor.
尽管已有报道称葡萄糖转运蛋白1（GLUT-1）在人类癌症中过表达，但葡萄糖进入胰腺癌的机制仍不清楚。为了评估GLUT葡萄糖转运蛋白与氟代脱氧葡萄糖（FDG）摄取之间的关系，对34例术前疑似胰腺肿瘤患者（平均年龄60.9岁）进行了FDG正电子发射断层扫描（PET），其中包括28例恶性肿瘤和6例良性肿瘤。
在禁食超过5小时后注射185MBq的[18F]FDG，50分钟时的FDG摄取以标准化摄取值（SUV）进行半定量分析。术后使用抗GLUT-1、-2、-3、-4和-5抗体对这些肿瘤的石蜡切片进行免疫组织化学研究，以获得免疫组织化学分级（“强”、“弱”和“阴性”），由三位经验丰富的医生进行评估。
在经组织学检查证实的26例恶性肿瘤中，23例（88%）肿瘤的GLUT-1葡萄糖转运蛋白表达呈阳性，17例（61%）呈强表达。另一方面，13例（46%）、0例（0%）、9例（36%）和13例（46%）恶性肿瘤的GLUT-2、-3、-4和-5葡萄糖转运蛋白表达分别呈阳性。6例良性肿瘤中有3例GLUT-1表达呈强阳性。关于GLUT-2、-3、-4和-5，只有1例良性肿瘤GLUT-5表达呈阳性。因此，GLUT-1在检测恶性肿瘤方面显示出相对较高的敏感性但较低的特异性（50%），而GLUT-2、-3、-4和-5的敏感性较低但特异性较高。SUV与GLUT免疫反应性分级之间的相关性在GLUT-1中具有显著性（强，4.49±2.95；弱，3.42±1.21；阴性，2.52±0.84）（p<0.05），而在其余四种GLUT转运蛋白中无显著性。
这些数据表明GLUT-1在恶性葡萄糖代谢中起重要作用，可能有助于胰腺肿瘤患者PET成像中FDG摄取增加。
