[18F]FDG Uptake and PCNA, Glut-1, and Hexokinase-II Expressions in Cancers and Inflammatory Lesions of the Lung

Abstract

PURPOSE: The aim of this study was to evaluate the relationships among [18F]fluorodeoxyglucose ([18F]-FDG) uptake, Glut-1 and HK-II expressions, and grade of inflammation in resected lung lesions. MATERIALS AND METHODS: Sixty patients had undergone preoperative 18F-FDG-PET imaging and thoracotomy. For semi-quantitative analysis of 18F-FDG uptake, partial volume effect corrected maximum standardized uptake values (pSUVs) were calculated. Immunohistochemical staining was performed in resected specimens using anti-Glut-1, anti-HK-II, and anti-proliferative cellular nuclear antigen (PCNA) antibodies, and immunoreactivities were scored as G-, H-, and P-indexes on a five-point scale (0: 0%; 1:~20%, 2:~40%; 3:~60%; 4:~80%, and 5:~100% percentages of strongly immunoreactive cells). Grade of inflammation was also evaluated. RESULTS: The malignant lesions had higher pSUV and higher G- and H-indexes than nonmalignant lesions. pSUVs correlated with the G- (p < .001), H- (p < .01), and P-indexes (p < 0.01) in malignant lesions. In adenocarcinomas, cancers with lower differentiation showed higher expression of Glut-1 and HK-II than those with higher differentiation. A positive linear regression was observed between pSUVs and the grading of inflammation in nonmalignant lesions (p < 0.05). CONCLUSIONS: Our study indicates that 18F-FDG uptake in lung cancer correlates well with Glut-1, HK-II, and PCNA expression. For nonmalignant lesions, the presence of a higher inflammatory process correlated with 18F-FDG uptake.

Keywords

• PCNA
• HK-II
• Glut-1
• [18F]FDG-PET
• lung cancer