早期鼻咽癌18F-FDG摄取与葡萄糖转运蛋白1及已糖激酶-Ⅱ过度表达的关系

Relationship between fluorodeoxyglucose uptake and overexpression of glucose transport protein 1 and hexokinase-Ⅱ in early-stage nasopharyngeal carcinoma

目的 测定并分析早期鼻咽癌18F-脱氧葡萄糖（FDG）摄取与肿瘤组织葡萄糖转运蛋白1（Glut1）及己糖激酶-Ⅱ（HK-Ⅱ）的表达,以探讨鼻咽癌组织摄取FDG的分子机制及其与肿瘤病理类型和分期的相关性.方法 40例早期鼻咽癌患者（T1期12例,T2期28例）行PET检查,测定病灶最大标准摄取值（SUVmax）及平均标准摄取值（SUVmean） 行鼻咽部肿瘤活组织检查,并采用免疫组织化学法测定其Glut1及HK-Ⅱ表达,计算阳性细胞百分率.T1与T2期患者SUVmax或SUVmean间的差异采用t检验,Glut1及HK-Ⅱ表达阳性率差异采用x2检验,SUVmax与Glut1和HK-Ⅱ表达间的关系采用Pearson相关分析.结果 40例患者SUVmax与SUVmean分别为9.45±1.87和6.04±1.09.T1期分别为8.95±1.91和5.61±1.08,T2期分别为11.55±1.70和7.98±1.10,T1期与T2期相比原发灶SUVmax（t=4.46,P＜0.001）及SUVmean（t=6.76,P＜0.001）差异均有统计学意义.40例早期鼻咽癌患者Glut1及HK-Ⅱ染色均为阳性,阳性细胞率分别为（45.2±10.9）%与（68.3±9.5）%.其中Glut1阳性细胞率在T1期和T2期分别为（38.4±8.1）%与（49.7±12.6）%,两者差异无统计学意义（x2=40.58,P＞0.05）,而HK-Ⅱ阳性细胞率在T1期与T2期分别为（60.1±11.1）%与（77.9±14.7）%,差异有统计学意义（x2=58.71,P＜0.05））.SUVmax与Glut1表达阳性细胞率呈低度正相关（r=0.369,P=0.019）,与HK-Ⅱ表达阳性细胞率呈中度正相关（r=0.549,P=0.001）.结论 早期鼻咽癌组织FDG摄取与Glut1过度表达相关.

Objective To discuss the molecular mechanism of 18F-fluorodeoxyglucose （FDG） uptake in tumor and to assess its value to identify pathologic type and cancer staging in patients with earlystage nasopharyngeal carcinoma.Methods Forty patients with nasopharyngeal carcinoma of early-stage,including 12 cases with T1 stage and 28 cases with T2 stage, underwent FDG PET imaging.The maximum standardized uptake value （ SUVmax ） and mean standardized uptake value （ SUVmean ） of FDG uptake of each patient were measured and compared between T1 and T2 stage by t-test.The expression of glucose transport protein 1 （ Glut1 ） and hexokinase- Ⅱ （ HK- Ⅱ ） of each case was measured in paraffin sections by streptavidin-perosidase （SP） immunohistochemistry.The positive expression rate of Glut1 and HK- Ⅱ was calculated and compared between T1 and T2 by x2 test.Meanwhile, the correlation between the expression of Glut1 or HK-Ⅱ and the SUVmax was tested by Pearson analysis.Results The SUVmax and SUVmean in 40 patients were 9.45 ± 1.87 and 6.04 ± 1.09, respectively.The SUVmax of patients with T1 stage （8.95 ± 1.91 ） was significantly lower （t =4.46, P〈0.001 ） than that of patients with T2 stage （11.55 ± 1.70）, and the SUVmean of patients with T1 stage （5.61 ± 1.08） was significantly lower （ t = 6.76, P 〈 0.001 ） than that of patients with T2 stage （7.98 ± 1.10） too.Among 40 patients, all patients showed positive expression of Glut1 and HK-Ⅱ , and the positive expression rate of Glut1 and HK-Ⅱ was （ 45.2 ± 10.9 ）% and （ 68.3 ±9.5）%, respectively.The positive expression rate of Glut1 was （38.4 ±8.1）% in T1 stage and （49.7 ±12.6）% in T2 stage, which displayed no difference （x2 =40.58, P〉0.05）, but the HK-Ⅱ positive expression rate showed significant difference （x2 =58.71, P〈0.05） between T1 stage （60.1 ±11.1）% and T2 stage （77.9 ± 14.7 ）%.The correlation analysis indicated that there was low-degree positive correlation （r =0.369, P=0.019） between the SUVmax and Glut1 expression, and there was medium-degree positive correlation （r = 0.549, P = 0.001 ） between the SUVmax and HK-Ⅱ expression.Conclusion Expression of Glut1 and HK-Ⅱ was positively correlated with FDG uptake in patients with early-stage nasopharyngeal carcinoma.