FDG uptake and glucose transporter type 1 and Ki-67 expressions in non-small-cell lung cancer: Correlations and prognostic values

1760 Objectives : FDG uptake mediated by glucose transporter type 1 (Glut-1) provides prognostic information in patients with non–small cell lung cancer (NSCLC). Tumor proliferative activity assessed by Ki-67 expression is another prognostic marker. Direct comparisons among FDG uptake and Glut-1 and Ki-67 expressions as prognostic indicators of NSCLC have not been reported. We investigated the prognostic significance of FDG uptake and Glut-1 and Ki-67 expressions and their correlations in patients with NSCLC. Methods : NSCLC patients (n=53, F:M=16:37, age 61.9±12.1 y) who underwent cure-intent resection after performing FDG PET were enrolled. Thirty-one patients had stage I, 15 with stage II and 7 with stage III. Patients were treated with surgery only (n=12), surgery plus adjuvant oral chemotherapy (n=32), or surgery plus adjuvant intravenous chemo- or radiotherapy (n=9). Maximum standardized FDG uptake values (maxSUV) and Glut-1 and Ki-67 expressions of the resected tumors were analyzed for their correlations and relations with tumor recurrence. The median follow-up duration was 15 mo. Results : Thirteen (24.5%) of 53 patients had a recurrence during a median follow-up of 8 mo. There were significant correlations among maxSUV and Glut-1 and Ki-67 expressions (r=0.48-0.79, p<0.001). Univariate analysis revealed that disease-free survival was significantly correlated with maxSUV (<7 vs. ≥7, p=0.001), % Ki-67 expression (<25% vs. ≥25%, p=0.047), tumor size (<3 cm vs. ≥3 cm, p=0.027), and differentiation of tumor cells (well/moderate vs. poor, p=0.025). However, multivariate Cox proportional analysis identified maxSUV as the single determinant for disease-free survival (p=0.027). Patients with maxSUV≥7 (n=14) had a significantly lower 1-year disease-free survival rate (57.1%) than those with maxSUV <7 (n=39, 89.7%). Conclusions : There were significant correlations among FDG uptake and Glut-1 and Ki-67 expressions. It seems that among various parameters FDG uptake is the most valuable prognostic indicator for tumor recurrence in patients with resected NSCLC. ![Graphic][1] [1]: /embed/inline-graphic-1.gif