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Correlation Between FDG Uptake by PET/CT and the Expressions of Glucose Transporter Type 1 and Hexokinase II in Cervical Cancer
  1. Seo-Yun Tong, MD,PhD*,
  2. Jong-Min Lee, MD,PhD*,
  3. Kyung-Do Ki, MD,PhD*,
  4. Young-Joon Choi, MD,PhD*,
  5. Hyun-Joo Seol, MD,PhD*,
  6. Seon-Kyung Lee, MD,PhD*,
  7. Chu-Yeop Huh, MD,PhD*,
  8. Gou-Young Kim, MD,PhD and
  9. Sung-Jig Lim, MD,PhD
  1. *Department of Obstetrics and Gynecology, and
  2. Department of Pathology, School of Medicine, Kyung Hee University, Seoul, South Korea.
  1. Address correspondence and reprint requests to Jong-Min Lee, MD, PhD, Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, #149 Sangil-Dong, Gangdong-Gu, Seoul 134-727, Korea. E-mail: kgo02@hanmail.net.

Abstract

Background The aim of this study was to explore the association between 2-deoxy-2-F18-fluoro-D-glucose uptake and the expressions of glucose transporter type 1 (GLUT-1) and hexokinase II (HK-II) in the lymph nodes of patients with cervical cancer.

Methods This prospective study included 20 women with International Federation of Gynecology and Obstetrics stage IB to stage IIA cervical cancer who underwent positron emission tomography (PET)–computed tomography (CT) (PET/CT) before surgical treatment. In 333 dissected lymph nodes (LNs) obtained, we examined the size, tumor involvement, and expressions of GLUT-1 and HK-II. These characteristics were compared with PET/CT and pathological findings.

Results Pathological analysis found that 21% (70) of the 333 surgically dissected LNs were metastatic. Positron emission tomography/CT detected metastasis with 22.8% sensitivity and 98.5% specificity. The levels of GLUT-1 and HK-II expression in false-positive LNs were higher than those in pathologically confirmed negative nodes (P = 0.015 and P = 0.001, respectively). In metastatic LNs, PET/CT-positive nodes were significantly different from PET/CT-negative nodes in mean size (P = 0.043), tumor involvement (P = 0.008), and proportion of GLUT-1–positive tumor cells (P = 0.042).

Conclusions Our results indicate that overexpression of GLUT-1 and HK-II may be related to 2-deoxy-2-F18-fluoro-D-glucose uptake in false-positive tissues on PET/CT. In metastatic lymph nodes, the ability of PET/CT to detect cancer may depend on tumor involvement, lymph node size, and GLUT-1 expression.

  • Cervical cancer
  • Lymph node metastasis
  • PET/CT
  • Glucose transporter 1
  • Hexokinase II

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Footnotes

  • This study was supported by the Kyung Hee University research fund in 2010 (KHU-20100767).

  • The authors declare no conflict of interest.

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