Elevated Metabolic Activity on 18F-FDG PET/CT Is Associated with the Expression of EZH2 in Non-small Cell Lung Cancer

Background/ Aim: Enhancer of zeste homolog 2 (EZH2) is a histone methyltransferase that is deeply involved in the pathogenesis of lung cancer. We evaluated the metabolic characteristics of non-small cell lung cancer (NSCLC) in patients with and without expression of EZH2 using 18Ffluorodeoxyglucose positron-emission tomography/computed tomography (F-18-FDG PET/CT). Materials and Methods: The EZH2 protein expression of 268 patients with resected NSCLC, whose preoperative F-18-FDG PET/CT information was available, was evaluated by immunohistochemistry with clone 6A10 antibody; cases with Allred score = 3 were considered positive. Results: Maximized standard uptake values in cases of EZH2-positive NSCLC and adenocarcinoma were significantly higher in comparison to EZH2-negative cases (p < 0.001, and p < 0.001, respectively). The expression of EZH2 in NSCLC and adenocarcinoma was associated with significantly poorer survival. Conclusion: In patients with NSCLC and adenocarcinoma, EZH2 positivity was associated with a high uptake of FDG, suggesting that EZH2 might define metabolically malignant lung cancer.