title: Hypoxia-inducible factor-1α, adrenomedullin and Bcl-2 although expected are not related to increased uptake of fluorine-18-fluorodeoxyglucose in endometrial cancer.
abstract: OBJECTIVE
  To study the relation between SUVmax, hypoxia inducible factor 1α (HIF-1α), angiogenetic factor adrenomedullin (AM) and antiapoptotic factor Bcl-2 in endometrial cancer.
  
  
  METHODS
  Thirthy eight patients who were diagnosed after a preoperative endometrial biopsy with endometrium cancer underwent pre-operative positron emission tomography/computed tomography (PET/CT) utilizing fluorine-18-fluorodeoxy glucose (¹⁸F-FDG). Maximum standardized uptake values (SUVmax) of the primary tumor were measured. After hysterectomy and bilateral salpingo-oophorectomy, microscopic slides of the 38 endometrial adenocarcinoma patients were evaluated by a surgical pathologist to confirm the diagnosis. Immunohistochemical staining for AM, Bcl-2 and HIF-1α was studied.
  
  
  RESULTS
  In all patients, ¹⁸F-FDG uptake was detected. The mean SUVmax of the tumors was 11.8 ± 5.9. Although SUVmax was higher in HIF-1α positive tumors, this finding was not statistically important. No correlation was found between SUVmax and HIF-1α positivity. Mean SUVmax was 6.4 ± 3 and 12.3 ± 1.4 in AM negative and AM positive patients, respectively. Mean SUVmax was 10.6 ± 4.9 and 12.3 ± 1.4 in Bcl-2 negative and Bcl-2 positive patients, respectively. We found no correlation between SUVmax, AM or Bcl-2 expression. Allred scores were not related with SUVmax in regression analysis.
  
  
  CONCLUSIONS
  Our study in a small number of patients is the first to show that SUVmax, although expected is not associated with HIF-1α, AM or with Bcl-2 in endometrial cancer. Increased uptake of ¹⁸F-FDG in endometrial cancer seems to be independent of HIF-1α and its downstream factors.
authors.affiliation: Department of Nuclear Medicine, Süleyman Demirel University, Isparta, 32260, Turkey. evrimmd@yahoo.com.
authors.forename: Sevim Sureyya
authors.initials: SS
authors.lastname: Cerci
authors.forename: Yakup
authors.initials: Y
authors.lastname: Yalcin
authors.forename: Kemal Kursat
authors.initials: KK
authors.lastname: Bozkurt
authors.forename: Ebru
authors.initials: E
authors.lastname: Erdemoglu
authors.forename: Burak
authors.initials: B
authors.lastname: Tatar
authors.forename: Evrim
authors.initials: E
authors.lastname: Erdemoglu
mesh_terms: D053607:Adrenomedullin / Q000378:metabolism*; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism*; D008875:Middle Aged; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015854:Up-Regulation
chemical_list: C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D019253:Proto-Oncogene Proteins c-bcl-2; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D053607:Adrenomedullin