Expression of GLUT-1 glucose transfer, cellular proliferation activity and grade of tumor correlate with [F-18]-fluorodeoxyglucose uptake by positron emission tomography in epithelial tumors of the ovary.

Abstract

We evaluated whether tracer FDG uptake, quantified as an SUV by PET in ovarian epithelial tumors, correlates with clinical stage, tumor grade, cell proliferation and glucose metabolism, all of which are biomarkers for response to chemotherapy, prognosis and overall survival in ovarian cancer patients. Seventeen patients suspected of having ovarian cancer by physical examination, tumor marker analysis and anatomic imaging (such as sonography, CT and/or MRI) underwent whole-body FDG-PET within the 2 weeks prior to surgery. Seventeen epithelial ovarian tumor specimens (13 malignant tumors, 5 at stage I, 2 at stage II, 6 at stage III; 2 borderline tumors; and 2 benign lesions) were available for pathologic evaluation. They were graded histopathologically, and immunohistochemistry for MIB-1 (proliferation index marker) and GLUT-1 was performed. Correlation between FDG uptake and clinical stage, GLUT-1 expression, MIB-1 LI and histologic grading score was determined. No positive correlation was observed between FDG uptake and clinical stage (p=0.14). Intensity of GLUT-1 expression (r=0.76, p=0.001), MIB-1 LI (r=0.457, p=0.014) and histologic grading score (r=0.692, p=0.005) showed statistically significant positive correlations with FDG uptake. Stepwise logistic regression analysis revealed that expression of GLUT-1 transporters was the strongest parameter (r=0.760, p=0.0004) by which to predict positive FDG uptake. Therefore, glucose consumption, as determined by analysis of SUVs in FDG-PET, may be a noninvasive biomarker for ovarian epithelial tumors.