Abstract
Purpose To determine the relationship between fructose 1,6-bisphosphatase 1 (FBP1) expression and fluorine 18 (18F) fluorodeoxyglucose (FDG) uptake in patients with clear cell renal cell carcinoma (ccRCC), and to investigate how 18F-FDG uptake and FBP1 expression are related to tumor metabolism and tumor differentiation grade. Materials and Methods A total of 54 patients with ccRCC underwent 18F-FDG combined positron emission tomography and computed tomography (PET/CT) before tumor resection. The maximum standardized uptake value (SUVmax) for the primary tumor was calculated from the 18F-FDG uptake. The relationship between SUVmax of primary tumor and the expression of FBP1, hexokinase 2 (HK2), and glucose transporter 1 (GLUT1) was analyzed via immunohistochemical analysis. Results We identified an inverse relationship between FBP1 expression and SUVmax (P=0.031). SUVmax was higher in patients with high-grade ccRCC (mean, 11.6 ± 5.0) than in those with low-grade ccRCC (mean, 3.8 ± 1.6, P < 0.001). FBP1 expression was significantly lower in patients with high-grade ccRCC (mean, 0.23 ± 0.1) than in those with low-grade ccRCC (mean, 0.57 ± 0.08; P=0.018). FBP1 status could be predicted with an accuracy of 66.7% when a SUVmax cutoff value of 3.55 was used. GLUT1 expression in ccRCC was positively correlated with 18F-FDG uptake and FBP1 status, whereas HK2 expression was not. Conclusion SUVmax in patients with ccRCC is inversely associated with the expression of FBP1, and FBP1 may inhibit 18F-FDG uptake via regulating GLUT1. SUVmax is higher in patients with high-grade ccRCC than in those with low-grade ccRCC, which could be the result of lower FBP1 expression in patients with high-grade ccRCC.
Highlights
Renal cell carcinoma (RCC) is one of the most prevalent tumors worldwide, with clear cell RCC as the most common histologic type [1, 2]
Patients underwent 18F-FDG positron emission tomography (PET)/computed tomography (CT) before tumor resection at Ren Ji Hospital between 2009 and 2016. e inclusion criteria were as follows: diagnosis of clear cell RCC (ccRCC) was confirmed by pathologic examination; complete clinical data, including age, sex, tumor size, lymph node metastasis, and tumor grade, were available; tissue specimens for immunohistochemical analysis were available; and follow-up information was available. ccRCCs were classified into 2 categories; tumors containing a nuclear G3 or G4 component and tumors consisting of G1 and G2 components
Our study showed that SUVmax was significantly higher in ccRCCs with low FBP1 expression compared with high FBP1 expression, indicating
Summary
Renal cell carcinoma (RCC) is one of the most prevalent tumors worldwide, with clear cell RCC (ccRCC) as the most common histologic type [1, 2]. The overall 5year survival rate of RCC patients is still poor [4]. Clinicians must make an early diagnosis to improve the survival rate of RCC patients. Fluorine 18 (18F) fluorodeoxyglucose- (FDG-) combined positron emission tomography (PET) and computed tomography (CT) has been widely used for evaluating tumor activity, which is based on the high rate of glucose metabolism in cancer cells [8,9,10,11]. Because 18F-FDG PET is increasingly being used as a diagnostic tool in RCC, a further characterization of this phenomenon is essential
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