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- Title
18F-FDG Uptake in Well-Differentiated Neuroendocrine Tumors Correlates with Both Ki-67 and VHL Pathway Inactivation.
- Authors
Bucau, Margot; Laurent-Bellue, Astrid; Poté, Nicolas; Hentic, Olivia; Cros, Jérôme; Mikail, Nidaa; Rebours, Vinciane; Ruszniewski, Philippe; Lebtahi, Rachida; Couvelard, Anne
- Abstract
<bold><italic>Background:</italic></bold>18F-FDG-PET scan positivity correlates with poor prognosis in neuroendocrine neoplasms (NEN). Glucose transporter 1 (GLUT1) and carbonic anhydrase 9 (CA9) are markers of aggressiveness in tumors. Together with von Hippel-Lindau protein (pVHL), they are involved in tumor cell metabolism via the hypoxia-inducible factor signaling pathway. The aim of this study was to compare, in a series of well-differentiated neuroendocrine tumors (NET), the 18F-FDG uptake and expression of the proliferation markers Ki-67, GLUT1, CA9, and pVHL. <bold><italic>Patients and Methods:</italic></bold> This retrospective study included 27 patients with well-differentiated NET. 18F-FDG-PET images were evaluated by the maximum standardized uptake value (SUVmax). GLUT1, CA9, and pVHL were analyzed by immunohistochemistry. <bold><italic>Results:</italic></bold> The NET were of pancreatic (<italic>n</italic> = 19), midgut (<italic>n</italic> = 4), duodenal (<italic>n</italic> = 1), esophageal (<italic>n</italic> = 1), rectal (<italic>n</italic> = 1), and pulmonary (<italic>n</italic> = 1) origin. Eight, 11, and 8 tumors were grade 1, 2, and 3, respectively. The mean/median Ki-67 index was 15/10% (1-60). The mean/median SUVmax was 6.2/5.2 (1.4-18.7). SUVmax correlated with greater tumor size (<italic>p</italic> = 0.03), higher expression of Ki-67 (<italic>p</italic> = 0.04), and lower expression of pVHL (<italic>p</italic> = 0.008). In the group of 16 NET with a low proliferative index (Ki-67 index <10%), 5/6 (83%) of the tumors with a high SUVmax had decreased pVHL expression (<italic>p</italic> = 0.0013). <bold><italic>Conclusion:</italic></bold> This study confirms that 18F-FDG-PET uptake correlates with both tumor size and proliferation in well-differentiated NET, and it highlights a subset of low-grade but 18F-FDG-PET-positive NET related to sporadic inactivation of the VHL pathway.
- Subjects
NEUROENDOCRINE tumors; TUMORS; GLUCOSE transporter 1 deficiency syndrome; CARBONIC anhydrase; PROTEINS
- Publication
Neuroendocrinology, 2018, Vol 106, Issue 3, p274
- ISSN
0028-3835
- Publication type
Article
- DOI
10.1159/000480239