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

Purpose: FDG uptake mediated by glucose transporter type 1 (Glut-1) and tumor proliferative activity assessed by Ki-67 expression provide prognostic information in patients with non-small-cell lung cancer (NSCLC). Here, we compared the prognostic significances of FDG uptake, and of Glut-1 and Ki-67 expressions in patients with NSCLC. Methods: NSCLC patients (n = 53, F:M = 16:37, age 61.9 +/- 12.1 years) who underwent curative resection after FDG-PET were enrolled. Thirty-one patients had stage I, 15 stage II, and 7 stage III disease. Patients were treated by surgery only (n = 12), surgery plus adjuvant oral chemotherapy (n = 32), or surgery plus adjuvant intravenous chemo- or radio-therapy (n = 9). Maximum standardized FDG uptake values (maxSUV), and the Glut-1 and Ki-67 expressions of resected tumors were analyzed for correlations and relations with tumor recurrence. The median follow-up duration was 15 months. Results: Thirteen (24.5%) of the 53 patients experienced recurrence during a median follow-up of 8 months and significant correlations were found between maxSUV, Glut-1, and Ki-67 expressions (r=0.48-0.79, p < 0.001). Univariate analysis revealed that disease-free survival (DFS) was significantly correlated with maxSUV (<= 7 versus >= 7, p=0.001), % Ki-67 expression (< 25% versus >= 25%, p=0.047), tumor size (< 3 cm versus >= 3 cm, p=0.027), and tumor cell differentiation (well/moderate versus poor, p =0.011). However, multivariate Cox proportional analysis identified maxSUV as the only determinant of DFS (p=0.005). Patients with a maxSUV of >7 (n=14) had a significantly lower I-year DFS rate (57.1 %) than those with a maxSUV of < 7 (n = 39, 89.7%). Conclusion: FDG uptake is more valuable than Glut-1 or Ki-67 expression in terms of predicting prognosis in patients with resected NSCLC. (c) 2006 Elsevier Ireland Ltd. All rights reserved.