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¹⁸F-FDG Uptake in Squamous Cell Carcinoma of the Cervix Is Correlated with Glucose Transporter 1 Expression

¹ Department of Nuclear Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
² Biostatistics Consulting Center/Department of Public Health, Chang Gung University, Taoyuan, Taiwan
³ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
⁴ Department of Human Genetics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
⁵ Department of Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
⁶ Institute of Nuclear Energy Research, Taoyuan, Taiwan
⁷ Department of Pathology, Veterans General Hospital-Taipei
⁸ Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

View larger version (134K): [in a new window]   FIGURE 1. (A) Normal cervical specimen from patient with uterine myoma, in which little Glut-1 was found in basal layer. (B) Patient with CIN-III and cervical specimen showed minimal expression of Glut-1 in its dysplastic cells. (C) Patient with stage IIB bulky cervical cancer. Overexpression of Glut-1 in cervical cancer tumor was observed, mainly in cervical cancer cell membrane. (D) Patient with cervical cancer who had previous radiation therapy and central recurrence. 18F-FDG PET scan was false-negative and only minimal Glut-1 expression was observed in specimen.

View larger version (19K): [in a new window]   FIGURE 2. Results of comparative analysis of primary and recurrent or persistent tumor from dual-phase 18F-FDG PET scans. Highly positive correlation between SUV1 and SUV2 was observed for primary tumor (r = 0.832, P < 0.001) and recurrent or persistent tumor (r = 0.973, P < 0.001).

View larger version (21K): [in a new window]   FIGURE 3. Results of comparative analysis of maximum SUV from dual-phase 18F-FDG PET scans and results of immunohistochemical staining. There is significant positive relationship of SUVs with Glut-1 expression (r = 0.74, P < 0.001 for SUV1; r = 0.65, P < 0.001 for SUV2).

View larger version (20K): [in a new window]   FIGURE 4. Comparison of results from work of Higashi et al. () and our data (•); slope of relation between Glut-1 expression and maximum SUV from dual-phase 18F-FDG PET scans is steeper for lung cancer than that for cervical cancer and correlation coefficients are larger (r = 0.74, P < 0.001 vs. r = 0.55, P < 0.001).

View larger version (21K): [in a new window]   FIGURE 5. If results for SUL are used in place of maximum SUV, our data (•) for cervical cancer show more significant correlation than data of Brown et al. () for lung cancer (r = 0.504, P < 0.001 vs. r = 0.007, P < 0.976).