J Korean Assoc Oral Maxillofac Surg.  2012 Aug;38(4):212-220. 10.5125/jkaoms.2012.38.4.212.

Correlation between glucose transporter type-1 expression and 18F-FDG uptake on PET in oral cancer

• Kim CH
• Kim MY

• KMID: 2189628
• DOI: http://doi.org/10.5125/jkaoms.2012.38.4.212

Abstract

OBJECTIVES
Fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) is a non-invasive diagnostic tool for many human cancers wherein glucose uptake transporter-1 (GLUT-1) acts as a main transporter in the uptake of 18F-FDG in cancer cells. Increased expression of glucose transporter-1 has been reported in many human cancers. In this study, we investigated the correlation between 18F-FDG accumulation and expression of GLUT-1 in oral cancer.
MATERIALS AND METHODS
We evaluated 42 patients diagnosed with oral squamous cell carcinoma (OSCC) and malignant salivary gland tumor as confirmed by histology. 42 patients underwent pre-operative 18F-FDG PET, with the maximum standardized uptake value (SUVmax) measured in each case. Immunohistochemical staining was done for each histological specimen, and results were evaluated post-operatively according to the percentage (%) of positive area, intensity, and staining score.
RESULTS
For OSCC, SUVmax significantly increased as T stage of tumor classification increased. For malignant salivary gland tumor, SUVmax significantly increased as T stage of tumor classification increased. For OSCC, GLUT-1 was expressed in all 36 cases. GLUT-1 staining score (GSS) increased as T stage of tumor classification increased, with the difference statistically significant. For malignant salivary gland tumor, GLUT-1 expression was observed in all 6 cases; average GSS was significantly higher in patients with cervical lymph node metastasis than that in patients without cervical lymph node metastasis. Average GSS was higher in OSCC (11.11+/-1.75) than in malignant salivary gland tumor (5.33+/-3.50). No statistically significant correlation between GSS and SUVmax was observed in OSCC or in malignant salivary gland tumor.
CONCLUSION
We found no statistically significant correlation between GSS and SUVmax in OSCC or in malignant salivary gland tumor. Studies on the various uses of GLUT during 18F-FDG uptake and SUV and GLUT as tumor prognosis factor need to be conducted through further investigation with large samples.

Keyword

Mouth neoplasms; Positron-emission tomography; Glucose transporter-1; Standardized uptake value

MeSH Terms

Carcinoma, Squamous Cell
Fluorodeoxyglucose F18
Glucose
Glucose Transport Proteins, Facilitative
Humans
Lymph Nodes
Mouth Neoplasms
Neoplasm Metastasis
Positron-Emission Tomography
Prognosis
Salivary Glands
Fluorodeoxyglucose F18
Glucose
Glucose Transport Proteins, Facilitative

Figure

• 

  Fig. 1 Well-differentiated squamous cell carcinoma in the oral floor of a 73-year-old man (case No. 2). A. Positron emission tomography. Coronal maximum intensity projection image with increased fluorodeoxyglucose accumulation in the right floor of mouth (arrow). B. Well-differentiated squamous cell carcinoma confirmed on H&E staining (×400). C. Immunohistochemical staining score for glucose uptake transporter-1 in tumor cells was 12 (strong intensity and more than 75% of positive area) (×400).

• 

  Fig. 2 Mucoepidermoid carcinoma in the right maxilla of a 43-year-old woman (case No. 37). A. Positron emission tomography (PET). Coronal maximum intensity projection image with increased fluorodeoxyglucose accumulation in the right floor of mouth (arrow). B. Fused PET and computed tomography images. A tumor shows maximum standardized uptake value of 3.2. C. Mucoepidermoid carcinoma confirmed on H&E staining (×200). D. Immunohistochemical staining score for glucose uptake transporter-1 in tumor cells was 4 (moderate intensity and 25-50% of positive area) (×200).

• 

  Fig. 3 Adenoid cystic carcinoma in the right maxilla of a 78-year-old woman (case No. 39). A. Positron emission tomography (PET). Coronal maximum intensity projection image with increased fluorodeoxyglucose accumulation in the right floor of mouth (arrow). B. Fused PET and computed tomography images. A tumor shows maximum standardized uptake value of 5.2. C. Adenoid cystic carcinoma confirmed on H&E staining (×200). D. Immunohistochemical staining score for glucose uptake transporter-1 in tumor cells was 2 (weak intensity and 25-50% of positive area) (×200).

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