Preoperative High Maximum Standardized Uptake Value in Association with Glucose Transporter 1 Predicts Poor Prognosis in Pancreatic Cancer.
BACKGROUND
The diagnosis of malignant diseases worldwide has been determined using18F-fluorodeoxyglucose positron emission tomography (FDG-PET). Glucose transporter type 1 (Glut-1) is a key protein associated with the accumulation of FDG in cancer cells. This study evaluated the relationship between Glut-1 expression and FDG accumulation to determine the usefulness of FDG-PET for prediction of long-term outcomes of pancreatic cancer.


METHODS
The expression of Glut-1 was immunohistochemically examined in 138 surgically resected pancreatic cancer specimens. The Glut-1-positive and Glut-1-negative groups were analyzed with respect to their clinicopathologic characteristics and prognosis. Before surgery, 93 patients underwent FDG-PET and measurement of the corrected maximum standardized uptake value (cSUVmax). The relationship between Glut-1 expression and cSUVmax were examined, and prognostic factors were identified using uni- and multivariate analyses.


RESULTS
Glut-1 was positive in 69 patients (50%). The median relapse-free and overall survival times were significantly shorter in the Glut-1-positive group (11 vs. 22 months, respectively) than in the Glut-1-negative group (23 vs. 42 months, respectively). The cSUVmax was significantly associated with long-term survival. The relapse-free and overall survival rates were significantly poorer in the high-cSUVmax group than in the low-cSUVmax group. Glut-1 expression was associated with cSUVmax accumulation. In the multivariate Cox regression analysis using forward stepwise selection, male gender, positive lymph node metastases, high CA19-9, and high cSUVmax were identified as independent prognostic factors for pancreatic cancer.


CONCLUSIONS
A significant relationship exists between high preoperative cSUVmax and Glut-1 expression. High cSUVmax is one of the prognostic factors for overall survival after resection of pancreatic cancer.
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Akira
A
Chikamoto
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Risa
R
Inoue
Department of Cell Pathology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Yoshiaki
Y
Komohara
Department of Biostatistics, Yokohama City University, Yokohama, Japan.
Kentaro
K
Sakamaki
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Daisuke
D
Hashimoto
Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Shinya
S
Shiraishi
Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
Hiroshi
H
Takamori
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Yo-Ichi
YI
Yamashita
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Naoya
N
Yoshida
Department of Biostatistics, Yokohama City University, Yokohama, Japan.
Takeharu
T
Yamanaka
Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Yasuyuki
Y
Yamashita
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan. hdobaba@kumamoto-u.ac.jp.
Hideo
H
Baba
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D005500:Follow-Up Studies; D051272:Glucose Transporter Type 1 / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D049268:Positron-Emission Tomography / Q000379:methods; D011300:Preoperative Care; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism; D012189:Retrospective Studies; D015996:Survival Rate
D014408:Biomarkers, Tumor; D051272:Glucose Transporter Type 1; D019275:Radiopharmaceuticals; C495677:SLC2A1 protein, human; D019788:Fluorodeoxyglucose F18