title: Expression of glucose transporter-1, hexokinase-II, proliferating cell nuclear antigen and survival of patients with pancreatic cancer.
abstract: OBJECTIVE
  18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) has been shown to be useful in diagnosis and staging of pancreatic cancer. However, the prognostic value of FDG-PET remains controversial. The aim of this study was to evaluate relations between the factors suggested to be related to the FDG accumulation in tumor tissue, such as glucose transporter-1 (GLUT-1), hexokinase type-II (HK-II), proliferating cell nuclear antigen (PCNA), and survival of pancreatic cancer patients.
  
  
  METHODS
  Histological specimen of pancreatic cancer obtained from seventy-four consecutive patients were evaluated for the expression of GLUT-1, HK-II, and PCNA by visual analysis of immunohistochemical staining of paraffin sections from the tumor specimens using anti-GLUT-1, anti-HK-II, and anti-PCNA antibody, respectively. The percentages of cells strongly expressing GLUT-1, HK-II and PCNA were scored on a 5-point scale (1 = 0-20 percent, 2 = 20-40 percent, 3 = 40-60 percent, 4 = 60-80 percent, 5 = 80-100 percent). After initial treatment, each patient was followed-up and survival time was recorded. Median survival curves of the patients with different levels of GLUT-1, HK-II, and PCNA expression were evaluated using the Kaplan-Meier method. Statistical significance of the differences in survival was calculated with the log rank test.
  
  
  RESULTS
  Median survival of examined patients showed no relation with the levels of GLUT-1 expression, while patients with low expression of HK-II (HK-II index < 3) had significantly shorter survival than those with higher expression of HK-II (HK-II index >/= 3) (6.5 +/- 4.1 versus 12.9 +/- 22.4 months, respectively, p < 0.05). Median survival of examined patients also showed significant relations with the levels of PCNA expression. Patients with low expression of PCNA (PCNA index < 4) had significantly longer survival than those with higher expression of PCNA (PCNA index >/= 4) (11.9 +/- 20.1 versus, 5.8 +/- 10.8 months, respectively, p < 0.01):
  
  
  CONCLUSIONS
  Our results showed that the expression of GLUT-1 had no prognostic value in the examined patients with pancreatic cancer. On the other hand, high levels of HK-II expression and low levels of PCNA expression may allow accurate identification of the patient with longer survival who may benefit from intensive anticancer treatment.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. andrej.lyschik@vanderbilt.edu
authors.forename: Andrej
authors.initials: A
authors.lastname: Lyshchik
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Higashi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakamoto
authors.forename: Koji
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Doi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Imamura
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Saga
authors.forename: Kaori
authors.initials: K
authors.lastname: Togashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D051272:Glucose Transporter Type 1 / Q000032:analysis*; D006593:Hexokinase / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000737:chemistry* / Q000201:enzymology / Q000276:immunology / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*; D013997:Time Factors
chemical_list: D051272:Glucose Transporter Type 1; D018809:Proliferating Cell Nuclear Antigen; D006593:Hexokinase