Abstract
BACKGROUND
The overexpression of glucose transporters, especially of Glutโ1, is a common characteristic of human malignancies, including head and neck carcinoma. Recently, the assessment of glucose metabolism in the tumor with [^18^F]โ2โfluoroโ2 deoxyโDโglucose (FDG) and positron emission tomography (FDGโPET) has been used to identify particularly aggressive tumors. The authors tested the hypothesis that both glucose transport and its metabolism play a key role in the progression of oral squamous cell carcinoma (OSCC).
METHODS
Retrospective analysis of Glutโ1 expression was performed by immunohistology in 118 patients with OSCC, and a Glutโ1 labeling index (LI) was established for each. A separate group of 44 patients with primary OSCC was evaluated prospectively by FDGโPET prior to surgery. To link the expression of Glutโ1 with glucose metabolism, both FDGโPET and immunohistology were determined in a subgroup of 31 patients, and the results were correlated with overall survival.
RESULTS
The patients who had OSCC with a low LI for Glutโ1 survived significantly longer compared with patients who had OSCC with a high LI (138 months vs. 60 months; P = 0.0034). It was found that Glutโ1 expression was an independent marker of prognosis in patients with OSCC. In patients who were evaluated by FDGโPET, the standardized uptake value (SUV) below the median split value of 5.6 was predictive of a longer survival (P < 0.027), whereas an SUV > 5.6 was associated with an increased hazard of death. In combination, a high Glutโ1 level and a high SUV predicted shorter survival (P < 0.005) for patients with OSCC. Patients who achieved a complete response to preoperative radiation tended to have tumors with low glucose metabolism, as defined by both the Glutโ1 LI and the SUV.
CONCLUSIONS
Both glucose transport and glucose metabolism determine the glycolytic tumor phenotype, which is a significant negative biomarker of prognosis and overall survival in patients with OSCC. Cancer 2003;97:1015โ24. ยฉ 2003 American Cancer Society.
DOI 10.1002/cncr.11159