18FDG uptake in oesophageal adenocarcinoma:: linking biology and outcome

Purpose Variable uptake of (18)FDG has been noticed in positron emission tomography (PET) studies of patients with oesophageal adenocarcinoma. The aim of the present study was to investigate biological parameters involved in (18)FDG uptake in oesophageal adenocarcinoma for selection of patients with increased (18)FDG uptake and prediction of prognostic value of (18)FDG PET. Patients and methods Preoperative PET scans were performed in 26 patients with histologically proven oesophageal adenocarcinoma. (18)FDG uptake was semiquantitatively measured by SUVBSAg. Tumour sections were stained by immunohistochemistry for angiogenic markers (VEGF, CD31), glucose transporter-1 (Glut-1), hexokinase (HK) isoforms, for proliferation marker (Ki67), for macrophage marker (CD68) and for apoptosis marker (cleaved caspase-3). Cell densities, differentiation grade, degree of necrosis and mucus, T-stage and tumour size were assessed. In addition follow-up was analysed. Results No association was found between (18)FDG uptake and angiogenic markers. In contrast, a significant correlation was found between (18)FDG uptake and Glut-1 expression. No correlations were found between (18)FDG uptake and HK isoforms, Ki67 or cleaved caspase-3. Also, no correlations were found between (18)FDG uptake and cell density, differentiation grade, CD68, mucus and necrosis. However, there was a significant correlation between (18)FDG uptake and tumour size and between (18)FDG uptake and tumour recurrence. Conclusions Glut-1 expression and tumour size seem parameters associated with (18)FDG uptake in patients with biopsy proven oesophageal adenocarcinoma, and may be used to select oesophageal cancer patients in whom (18)FDG-PET is of diagnostic value and may predict disease outcome.