Correlation between 18F-FDG Uptake and Clinicopathological Characteristics of StageⅠNon-small Cell Lung Cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

1. Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing 100029, P. R. China;
2. Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing 100029, P. R. China;
3. Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, P. R. China;
4. Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, P. R. China;

Corresponding?author：

Keywords：

Non-small cell lung cancer; Positron emission tomography/computed tomography; Deoxyglucose; Standardized uptake value; Pathology

DOI：

10.7507/1007-4848.20150088

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Objective To analyze the relationship between maximum standardized uptake value (SUVmax) of primary tumor detected by 18F-FDG positron emission tomography/computed tomography (PET/CT) and clinicopathologic factors in stageⅠnon-small cell lung cancer (NSCLC), and investigate the prognostic value of PET/CT on pathological feature. Methods We retrospectively analyzed clinical data of 182 patients with stageⅠNSCLC who underwent 18F-FDG PET/CT scan before lobectomy or segmentectomy in China-Japan Friendship Hospital from April 2013 to June 2014. There were 121 male and 61 female patients with their ages of 34-85 (68.1±9.8) years. Clinicopathologic factors including sex, age, smoking history, histology, TNM stage, T stage, tumor size, lymphatic vessel invasion, blood vessel invasion (BVI) and visceral pleural invasion were evaluated to identify the independent factors affecting SUVmax by univariate and multivariate regression analysis. The diagnostic efficiency and best cut-off point of SUVmax were calculated by the receiver operating characteristic curve. Results The univariate analysis identified that sex (P=0.015), smoking history (P=0.001), histology (P < 0.001), TNM stage (P=0.004), T stage (P=0.001), tumor size (P < 0.001), BVI (P=0.001) were factors affecting SUVmax. Only histology (P=0.001), tumor size (P=0.006), BVI (P=0.009) were found to be significant independent factors according to multivariate regression analysis. The SUVmax of primary tumor was a predictor for BVI with the highest diagnostic accuracy at a cut-off value of 4.85, the sensitivity and specificity were 65.5% and 71.7%. Conclusion The SUVmax is correlated with histology, tumor size and BVI in stageⅠNSCLC, higher in patients with non-adenocarcinoma, lager tumor and positive BVI. Furthermore, the probability of BVI could be predicted by SUVmax of the primary tumor.

Citation： QIANGGuang-liang, XURui, LiuJie, XUYan-yan, DIJin-xi, DAJi-ping, LIANGChao-yang, SONGZhi-yi, TIANYan-chu, SHIBin, GUOYong-qing, LIUDe-ruo. Correlation between 18F-FDG Uptake and Clinicopathological Characteristics of StageⅠNon-small Cell Lung Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(4): 317-322. doi: 10.7507/1007-4848.20150088 Copy

1.	Tanoue LT, Detterbeck FC.New TNM classification for non-small-cell lung cancer.Expert Rev Anticancer Ther, 2009, 9(4):413-423.
2.	Lardinois D, De Leyn P, Van Schil P, et al.ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer.Eur J Cardiothorac Surg, 2006, 30(5):787-792.
3.	Vallieres E, Shepherd FA, Crowley J, el al.The IASLC Lung Cancer Staging Project:proposals regarding the relevance of TNM in the pathologic staging of small cell lung cancer in the forthcoming (seventh) edition of the TNM classification for lung cancer.J Thorac Oncol, 2009, 4(9):1049-1059.
4.	Lu P, Yu L, Li Y, et al.A correlation study between maximum stan-dardized uptake values and pathology and clinical staging in nons-mall cell lung cancer.Nucl Med Commun, 2010, 31(7):646-651.
5.	Hara T, Kosaka N, Suzuki T, et al.Uptake rates of 18F-fluorodeox-yghcose and 11C-choline in lung cancer and pulmonary tubercu-losis:a positron emission tomography study.Chest, 2003, 124(3):893-901.
6.	李明煥, 胡漫, 張品良, 等.T1期肺癌原發灶18F-FDG攝取與轉移的關系.中華核醫學雜志, 2008, 28(4):255-257.
7.	Port JL, Andrade RS, Levin MA, et al.Positron emission tomographic scanning in the diagnosis and staging of non-small cell lung cancer 2 cm in size or less.J Thorac Cardiovasc Surg, 2005, 130(6):1611-1615.
8.	王淑俠, 徐衛平, 李東江, 等.從標準攝取值預測腫瘤的侵襲性:206例肺癌PET分析.中國醫學影像技術, 2006, 22(5):770-772.
9.	Aquino SL, Halpern EF, Kuester LB, et al.FDG-PET and CT features of non-small cell lung cancer based on tumor type.Int J Mol Med, 2007, 19(3):495-499.
10.	劉芳穎, 王全師, 裴著果.非小細胞肺癌18F-FDG PET顯像與增殖細胞核抗原表達的關系.中華核醫學雜志, 2003, 23(1):14-16.
11.	Jadvar H, Alavi A, Gambhir SS.18F-FDG uptake in lung, breast, and colon cancers:molecular biology correlates and disease characterization.J Nucl Med, 2009, 50(11):1820-1827.
12.	Brown RS, Leung JY, Kison PV, et al.Glucose transporters and FDG uptake in untreated primary human non-small cell lung cancer.J Nucl Med.1999, 40(4):556-565.
13.	段鈺, 于麗娟, 陸佩歐, 等.非小細胞肺癌PET-CT標準攝取值與葡萄糖轉運蛋白1和微血管密度及Ki67表達的相關性.中華腫瘤雜志, 2008, 30(10):764-767.
14.	de Geus-Oei LF, van Krieken JH, Aliredjo RP, et al.Biological correlates of FDG uptake in non-small cell lung cancer.Lung Cancer, 2007, 55(1):79-87.
15.	Higashi K, Ueda Y, Sakurai A, et al.Correlation of Glut-1 glucose transporter expression with[(18) F]FDG uptake in non-small cell lung cancer.Eur J Nucl Med, 2000, 27(12):1778-1785.
16.	汪濤, 孫玉鶚, 姚樹林, 等.細支氣管肺泡癌葡萄糖易化擴散轉運蛋白-1表達特點及與18F-脫氧葡萄糖攝取的關系.中國胸心血管外科臨床雜志, 2005, 12(6):381-385.
17.	周世杰, 許紹發, 張海青, 等.血管生成及血管浸潤與Ⅰ期非小細胞肺癌的預后分層.中國肺癌雜志, 2007, 10(1):29-33.
18.	Hishida T, Yoshida J, Maeda R, et al.Prognostic impact of intratu-moural microvascular invasion and microlymphatic permeation on node-negative non-small-cell lung cancer:which indicator is the stronger prognostic factor?Eur J Cardiothorac Surg, 2013, 43(4):772-777.
19.	Kudo Y, Saji H, Shimada Y, et al.Proposal on incorporating blood vessel invasion into the T classification parts as a practical staging system for stageⅠnon-small cell lung cancer.Lung Cancer, 2013, 81(2):187-193.
20.	Mineo TC, Ambrogi V, Baldi A, et al.Prognostic impact of VEGF, CD31, CD34, and CD105 expression and tumour vessel invasion after radical surgery forⅠB-ⅡA non-small cell lung cancer.J Clin Pathol, 2004, 57(6):591-597.
21.	Tsuchiya T, Hashizume S, Akamine S, et al.Upstaging by vessel invasion improves the pathology staging system of non-small cell lung cancer.Chest, 2007, 132(1):170-177.
22.	Pechet TT, Carr SR, Collins JE, et al.Arterial invasion predicts early mortality in stageⅠnon-small cell lung cancer.Ann Thorac Surg, 2004, 78(5):1748-1753.
23.	Ito S, Fukusato T, Nemoto T, et al.Coexpression of glucose transporter 1 and matrix metalloproteinase-2 in human cancers.J Natl Cancer Inst, 2002, 94(14):1080-1091.
24.	Ito H, Duxbury M, Zinner MJ, et al.Glucose transporter-1 gene expression is associated with pancreatic cancer invasiveness and MMP-2 activity.Surgery, 2004, 136(3):548-556.
25.	閆圓圓, 黃勇, 李文武, 等.食管鱗狀細胞癌FDG PET/CT顯像SUVmax與腫瘤增殖、侵襲和血管生成的關系.中華核醫學與分子影像雜志, 2012, 32(1):36-38.

1. Tanoue LT, Detterbeck FC.New TNM classification for non-small-cell lung cancer.Expert Rev Anticancer Ther, 2009, 9(4):413-423.
2. Lardinois D, De Leyn P, Van Schil P, et al.ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer.Eur J Cardiothorac Surg, 2006, 30(5):787-792.
3. Vallieres E, Shepherd FA, Crowley J, el al.The IASLC Lung Cancer Staging Project:proposals regarding the relevance of TNM in the pathologic staging of small cell lung cancer in the forthcoming (seventh) edition of the TNM classification for lung cancer.J Thorac Oncol, 2009, 4(9):1049-1059.
4. Lu P, Yu L, Li Y, et al.A correlation study between maximum stan-dardized uptake values and pathology and clinical staging in nons-mall cell lung cancer.Nucl Med Commun, 2010, 31(7):646-651.
5. Hara T, Kosaka N, Suzuki T, et al.Uptake rates of 18F-fluorodeox-yghcose and 11C-choline in lung cancer and pulmonary tubercu-losis:a positron emission tomography study.Chest, 2003, 124(3):893-901.
6. 李明煥, 胡漫, 張品良, 等.T1期肺癌原發灶18F-FDG攝取與轉移的關系.中華核醫學雜志, 2008, 28(4):255-257.
7. Port JL, Andrade RS, Levin MA, et al.Positron emission tomographic scanning in the diagnosis and staging of non-small cell lung cancer 2 cm in size or less.J Thorac Cardiovasc Surg, 2005, 130(6):1611-1615.
8. 王淑俠, 徐衛平, 李東江, 等.從標準攝取值預測腫瘤的侵襲性:206例肺癌PET分析.中國醫學影像技術, 2006, 22(5):770-772.
9. Aquino SL, Halpern EF, Kuester LB, et al.FDG-PET and CT features of non-small cell lung cancer based on tumor type.Int J Mol Med, 2007, 19(3):495-499.
10. 劉芳穎, 王全師, 裴著果.非小細胞肺癌18F-FDG PET顯像與增殖細胞核抗原表達的關系.中華核醫學雜志, 2003, 23(1):14-16.
11. Jadvar H, Alavi A, Gambhir SS.18F-FDG uptake in lung, breast, and colon cancers:molecular biology correlates and disease characterization.J Nucl Med, 2009, 50(11):1820-1827.
12. Brown RS, Leung JY, Kison PV, et al.Glucose transporters and FDG uptake in untreated primary human non-small cell lung cancer.J Nucl Med.1999, 40(4):556-565.
13. 段鈺, 于麗娟, 陸佩歐, 等.非小細胞肺癌PET-CT標準攝取值與葡萄糖轉運蛋白1和微血管密度及Ki67表達的相關性.中華腫瘤雜志, 2008, 30(10):764-767.
14. de Geus-Oei LF, van Krieken JH, Aliredjo RP, et al.Biological correlates of FDG uptake in non-small cell lung cancer.Lung Cancer, 2007, 55(1):79-87.
15. Higashi K, Ueda Y, Sakurai A, et al.Correlation of Glut-1 glucose transporter expression with[(18) F]FDG uptake in non-small cell lung cancer.Eur J Nucl Med, 2000, 27(12):1778-1785.
16. 汪濤, 孫玉鶚, 姚樹林, 等.細支氣管肺泡癌葡萄糖易化擴散轉運蛋白-1表達特點及與18F-脫氧葡萄糖攝取的關系.中國胸心血管外科臨床雜志, 2005, 12(6):381-385.
17. 周世杰, 許紹發, 張海青, 等.血管生成及血管浸潤與Ⅰ期非小細胞肺癌的預后分層.中國肺癌雜志, 2007, 10(1):29-33.
18. Hishida T, Yoshida J, Maeda R, et al.Prognostic impact of intratu-moural microvascular invasion and microlymphatic permeation on node-negative non-small-cell lung cancer:which indicator is the stronger prognostic factor?Eur J Cardiothorac Surg, 2013, 43(4):772-777.
19. Kudo Y, Saji H, Shimada Y, et al.Proposal on incorporating blood vessel invasion into the T classification parts as a practical staging system for stageⅠnon-small cell lung cancer.Lung Cancer, 2013, 81(2):187-193.
20. Mineo TC, Ambrogi V, Baldi A, et al.Prognostic impact of VEGF, CD31, CD34, and CD105 expression and tumour vessel invasion after radical surgery forⅠB-ⅡA non-small cell lung cancer.J Clin Pathol, 2004, 57(6):591-597.
21. Tsuchiya T, Hashizume S, Akamine S, et al.Upstaging by vessel invasion improves the pathology staging system of non-small cell lung cancer.Chest, 2007, 132(1):170-177.
22. Pechet TT, Carr SR, Collins JE, et al.Arterial invasion predicts early mortality in stageⅠnon-small cell lung cancer.Ann Thorac Surg, 2004, 78(5):1748-1753.
23. Ito S, Fukusato T, Nemoto T, et al.Coexpression of glucose transporter 1 and matrix metalloproteinase-2 in human cancers.J Natl Cancer Inst, 2002, 94(14):1080-1091.
24. Ito H, Duxbury M, Zinner MJ, et al.Glucose transporter-1 gene expression is associated with pancreatic cancer invasiveness and MMP-2 activity.Surgery, 2004, 136(3):548-556.
25. 閆圓圓, 黃勇, 李文武, 等.食管鱗狀細胞癌FDG PET/CT顯像SUVmax與腫瘤增殖、侵襲和血管生成的關系.中華核醫學與分子影像雜志, 2012, 32(1):36-38.

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Correlation between 18F-FDG Uptake and Clinicopathological Characteristics of StageⅠNon-small Cell Lung Cancer

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