Correlation Between Glucose Metabolism Parameters Derived From FDG and Tumor TNM Stages and Metastasis-Associated Proteins in Colorectal Carcinoma Patients

Abstract

Background The aim of this study was to investigate the relationship between multiple metabolism parameters derived from FDG and tumor TNM stages as well as tumor metastasis-associated protein of GLUT-1 and MACC1 in colorectal carcinoma (CRC). Methods 38 patients (24 male and 14 female) with primary CRC confirmed by elective surgery pathological, who also underwent 18F-FDG PET/CT scans between 2017 and 2019 were included in this study. Tumor T, N and M classification according to the 7th American Joint Committee on Cancer (AJCC). 18F-FDG parameters of SUVmax，SUVmean, TLG and MTV were measured by drawing a region of interest on the primary lesions. The expression of GLUT-1 and MACC1 was quantified by immunohistochemical and the correlation between metabolism parameters and tumor biomarkers were analyzed. Results According to our analysis, the 18F-FDG parameters of SUVmean was significantly correlated with tumor M status (P=0.000) of primary CRC. The primary tumor lesion with higher SUVmax, TLG and MTV values prone to a high-T status (P=0.002, 0.002 and 0.001, respectively). The high expression of GLUT-1/MACC1 were more frequently involved with T3-4 stage and poorly differentiated in CRC patients. Multivariate analysis found that the expression of GLUT-1 protein was correlated with SUVmax and MTV (R2=0.42, P=0.013 and 0.004, respectively), moreover, the expression of MACC1 protein was correlated with TLG (R2=0.372, P=0.000).Conclusion Glucose metabolism parameters derived from FDG provides a noninvasive assessment of M status and T status in CRC patients. The expression of GLUT-1 and MACC1 was associated with 18F-FDG uptake in CRC patients.

Visualization of metabolic parameters after colorectal carcinoma patients using [68Ga]Ga-FAPI PET

“…Under different SUVmax thresholds, SUVmax 30% and SUVmax 40% showed the same diagnostic e cacy, and the AUCs for predicting T3 from T4 were the same (0.748). The cutoff values were 8.803 and 8.758, and the cutoff value of FAPI was lower than that of FDG in a previous study [17]. However, because FAPI has a better target-background ratio, it can also achieve satisfactory visual effects, which is in accordance with the initial results obtained by Kömek et al [19].…”

“…The T stage is a key factor in determining the optimal therapeutic plan in patients with CRC [4,24], such as surgery only, neoadjuvant chemoradiotherapy plus surgery, or de nitive chemoradiotherapy. Glucose metabolism parameters derived from FDG and tumor T stage have previously been reported [17]. Primary tumor lesions with higher SUVmax, TLG, and MTV values were prone to a high-T status.…”

“…Zhang et al [17] evaluated 38 patients and found that an SUVmax cutoff value of 18.75 showed a sensitivity of 100% and speci city of 70.6%, an MTV cutoff value of 30.5 had a sensitivity of 100% and speci city of 82.4%, and a TLG cutoff value of 275.85 showed a sensitivity of 100% and speci city of 88.2% in distinguishing CRC T3 from T4 status. In our study, we evaluated the predictive performance under different thresholds of SUVmax (30%-60%) and SUVmean (30%-50%); SUVmean 30% demonstrated the highest predictive performance among the metabolic parameters (p<0.050), with an AUC of 0.761 (95% CI: 0.591-0.931), a sensitivity of 67.4% (95% CI: 0.472-0.681), and a speci city of 90.0% (95% CI: 0.557-0.796), respectively.…”

“…Gallium 68 ( 68 Ga)-conjugated broblast-activation protein inhibitor (FAPI) is a new radiotracer that has been developed and used for targeting broblast-activation proteins (FAPs) and visualizing tumor stroma [11][12][13][14]. It shows favorable pharmacokinetics and biodistribution in vivo, as well as a clear delineation of primary tumors and their metastases [12,[15][16][17][18], for example, in gastrointestinal tumors [19,20]. It can change the TNM (T stage: extent of the tumor; N stage: extent of the spread to the lymph nodes; and M stage: presence of metastasis) status and tumor treatment [20].…”

Obesity, colorectal cancer and MACC1 expression: A possible novel molecular association

“…Since the discovery of MACC1, the authors of the present study, as well as several other research groups have demonstrated the clinical significance of MACC1 as a causal, prognostic and predictive biomarker for >20 solid cancer types (14), including meta-analyses for solid cancers, cancers of the digestive system, colorectal, hepatocellular, gastric, gynecological and breast cancer (17)(18)(19)(20)(21)(22). The causal contribution of MACC1 for rewiring cell metabolism has been demonstrated by the authors of the present study, as well as others (23)(24)(25). A recent study reported MACC1-driven metabolic networks in CRC, such as rewiring glucose and glutamine metabolism, an increase in glucose use by the enhanced surface of glucose transporter 1 (GLUT1) or an increase in glutamine and pyruvate use by enhanced uptake (25).…”