Relationship between 18F-fluorodeoxyglucose uptake in primary lesions and clinicopathological characteristics of esophageal squamous cell carcinoma patients

Mingping Sun,Baosheng Li,Jian Zhang,Rui Feng,Hongfu Sun,Hongsheng Li,Zheng Fu,Yumei Wei

doi:10.3892/etm.2012.772

Abstract

The aim of this study, was to investigate the relationship between 18F-fluorodeoxyglucose (18F-FDG) uptake in primary tumors and the clinicopathological characteristics of esophageal squamous cell carcinoma (ESCC) patients. Patients with histopathologically diagnosed ESCC who had received a pre-therapeutic 18F-FDG positron emission tomography-computed tomography (PET-CT) scan were enrolled in the study. The maximum standardized uptake value (SUVmax) and the length of the primary tumor were measured by PET-CT. The clinical tumor-node-metastasis (TNM) stage was determined mainly by PET-CT images according to the American Joint Committee on Cancer (AJCC) staging system, 2002. A significant difference was observed in SUVmax between the length and T stage of the primary tumor (P=0.000 and P=0.017, respectively), but not in the grade of tumor differentiation (P=0.383), clinical stage (P=0.583), N staging (P=0.387), M staging (P=0.886), patient age (P= 0.752) or gender (P=0.233). There was a significant positive correlation between the SUVmax and the length of the tumor (r=0.456, P=0.000) and the depth of invasion of the primary tumor (r=0.257, P=0.006). After controlling for length, no statistically significant correlation was found between T stage and SUVmax (r=0.074, P=0.537). In conclusion, these findings suggest that tumor length influences FDG uptake in ESCC tumors, and that the T stage of the primary tumor is not significantly correlated with the SUVmax after controlling for length. However, we did not find a significant correlation between the SUVmax and primary tumor differentiation and clinical stage. These data provide important information for the management of ESCC.

Highlights

Esophageal carcinoma is one of the most common malignant tumors occurring in patients throughout the world, and esophageal squamous cell carcinoma (ESCC) is the most common type occurring in China
Studies have demonstrated that 18F‐FDG uptake on PET might be useful for assessing biological aggressiveness of tumor in vivo [7,8], and the standardized uptake value (SUV) as a semi‐quantitative parameter of FDG PET may accurately represent the intensity of metabolic activity of the primary tumor [9]
Our results demonstrated a significant difference in SUVmax among the different lengths and T stages of the primary tumors (P=0.000 and 0.017, respectively)

Summary

Introduction

Esophageal carcinoma is one of the most common malignant tumors occurring in patients throughout the world, and esophageal squamous cell carcinoma (ESCC) is the most common type occurring in China. The 5‐year overall survival (OS) rate of esophageal carcinoma patients is approximately 20%, even when the tumor is resected early on in the course of the disease [1]. Previous studies have suggested that tumor staging, length, and grade of differentiation are powerful prognostic factors for predicting patient survival [2,3]. The maximum SUV (SUVmax) was considered to be associated with tumor differentiation and clinical stage as well as predict survival for most esophageal adenocarcinomas [9,11,12]. Other studies did not find any significant correlation between SUVmax and tumor differentiation and tumor‐node‐metastasis (TNM) stage for non‐small‐cell lung cancer or ESCC [7,13]. To the best of our knowledge, the relationship between SUVmax and the clinicopathological characteristics of tumors is still controversial and information on esophageal carcinoma is scarce, especially for ESCC

Methods

Results

Conclusion