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.	李明焕, 胡漫, 张品良, 等.T1期肺癌原发灶18F-FDG摄取与转移的关系.中华核医学杂志, 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.	王淑侠, 徐卫平, 李东江, 等.从标准摄取值预测肿瘤的侵袭性:206例肺癌PET分析.中国医学影像技术, 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.	刘芳颖, 王全师, 裴著果.非小细胞肺癌18F-FDG PET显像与增殖细胞核抗原表达的关系.中华核医学杂志, 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.	段钰, 于丽娟, 陆佩欧, 等.非小细胞肺癌PET-CT标准摄取值与葡萄糖转运蛋白1和微血管密度及Ki67表达的相关性.中华肿瘤杂志, 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.	汪涛, 孙玉鹗, 姚树林, 等.细支气管肺泡癌葡萄糖易化扩散转运蛋白-1表达特点及与18F-脱氧葡萄糖摄取的关系.中国胸心血管外科临床杂志, 2005, 12(6):381-385.
17.	周世杰, 许绍发, 张海青, 等.血管生成及血管浸润与Ⅰ期非小细胞肺癌的预后分层.中国肺癌杂志, 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.	闫圆圆, 黄勇, 李文武, 等.食管鳞状细胞癌FDG PET/CT显像SUVmax与肿瘤增殖、侵袭和血管生成的关系.中华核医学与分子影像杂志, 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. 李明焕, 胡漫, 张品良, 等.T1期肺癌原发灶18F-FDG摄取与转移的关系.中华核医学杂志, 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. 王淑侠, 徐卫平, 李东江, 等.从标准摄取值预测肿瘤的侵袭性:206例肺癌PET分析.中国医学影像技术, 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. 刘芳颖, 王全师, 裴著果.非小细胞肺癌18F-FDG PET显像与增殖细胞核抗原表达的关系.中华核医学杂志, 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. 段钰, 于丽娟, 陆佩欧, 等.非小细胞肺癌PET-CT标准摄取值与葡萄糖转运蛋白1和微血管密度及Ki67表达的相关性.中华肿瘤杂志, 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. 汪涛, 孙玉鹗, 姚树林, 等.细支气管肺泡癌葡萄糖易化扩散转运蛋白-1表达特点及与18F-脱氧葡萄糖摄取的关系.中国胸心血管外科临床杂志, 2005, 12(6):381-385.
17. 周世杰, 许绍发, 张海青, 等.血管生成及血管浸润与Ⅰ期非小细胞肺癌的预后分层.中国肺癌杂志, 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. 闫圆圆, 黄勇, 李文武, 等.食管鳞状细胞癌FDG PET/CT显像SUVmax与肿瘤增殖、侵袭和血管生成的关系.中华核医学与分子影像杂志, 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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