Abstract
ObjectiveEvaluation of 18F-FDG uptake value via PET is central to current methods of diagnosis and staging of non-small cell lung cancer (NSCLC) due to its ability to evaluate expression levels of key regulators associated with glucose metabolism in tumor cells. Tp53-induced glycolysis and apoptosis regulator (TIGAR) is an important P53-induced protein that can inhibit glycolysis; however, there have been few clinical studies on its mechanism. Here we have investigated the relationship between TIGAR expression and 18F-FDG PET in tumors, along with its relationship with the clinical characteristics of NSCLC.MethodsWe analyzed SUVmax in 79 patients with NSCLC through immunohistochemical staining of TIGAR and five other biological markers associated with tumor cell glycolysis, in order to evaluate the correlation between their expression and SUVmax. We also plotted Kaplan-Meier survival curves to assess TIGAR expression with the prognosis and survival of patients with NSCLC.ResultsThe key findings were as follows: SUVmax was negatively correlated with the expression of TIGAR (r = −0.31, p<0.01); TIGAR expression was correlated with tumor size (p = 0.01), histological type (p<0.01), differentiation degree (p<0.01) and lymph node metastasis(p<0.01) in patients with NSCLC; and the survival time of patients whose TIGAR was negatively expressed was significantly shorter than for those whose TIGAR was positively expressed (P = 0.023).ConclusionsThe expression of TIGAR in primary tumors is significantly correlated with SUVmax, and low expression of TIGAR may predict a worse clinical outcome in patients with NSCLC.
Highlights
Unlike normal cells, most cancer cells depend on a high rate of glycolysis for energy production during malignant progression
This effect has been exploited in 18Ffluorodeoxyglucose positron emission tomography/computerized tomography (18F-FDG PET/CT) technologies, which has proved highly successful in clinical practice and is widely applied in tumor diagnosis [2,3]
Study Population This was a retrospective study of all patients who were confirmed to have non-small cell lung cancer (NSCLC) based on histopathological finding and underwent surgery after 18F-FDG PET/CT between December 2006 and December 2009 at Shanghai Jiaotong University affiliated Renji Hospital and Shanghai Chest Hospital
Summary
Most cancer cells depend on a high rate of glycolysis for energy production during malignant progression. This is known as the Warburg effect and is considered the seventh hallmark of cancer [1]. The maximal standardized uptake value (SUVmax) determined through PET imaging is a simple and reliable method of evaluating the glucose uptake capacity of tumors in vivo. It is defined as the ratio of activity in tissue per unit volume to the activity in the injected dose per patient body weight [4]. A high SUVmax has been linked with poor prognosis in cancer patients [7]
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