Correlation Between Biological Marker Expression and Fluorine-18 Fluorodeoxyglucose Uptake in Hepatocellular Carcinoma

Objectives: This study investigated the association between several biological markers and fluorine-18 fluorodeoxyglucose (FDG) uptake in patients with hepatocellular carcinoma. Methods: Forty-two patients with hepatocellular carcinoma who underwent FDG positron emission tomography were included in the study Tumor sections were immunohistochemically stained for phosphorylated signal transducer and activator of transcription 3 (pSTAT3), hypoxia-inducible factor 1 alpha (HIF1 alpha), glucose transporter 1 (GLUT1), GLUT2, GLUT3, and GLUT4. Results: The high standardized uptake value (SUV) group showed larger tumor size, more frequent vascular invasion, and poorer differentiation compared with the low SUV group. The high SUV group also showed significantly higher immunohistochemical expression of pSTAT3, HIF1 alpha, and GLUT1. The GLUT1 high-expression group showed higher alpha-fetoprotein (a tumor marker) and poorer differentiation than did the GLUT1 low-expression group. Conclusions: Our study indicates that FDG uptake is associated with the expression of pSTAT3, HIF1 alpha, and GLUT1 in hepatocellular carcinoma. The expression of these proteins shows a correlation with poor differentiation and vascular invasion.