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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2020.tde-17062021-100937
Document
Author
Full name
Fernando Simionato Perrotta
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2020
Supervisor
Committee
Júnior, Ulysses Ribeiro (President)
Begnami, Maria Dirlei Ferreira de Souza
Sapienza, Marcelo Tatit
Szor, Daniel José
Title in Portuguese
FDG-PET/CT no adenocarcinoma de esôfago, da junção esôfago gástrica e do estômago: análise da associação de SUV, MTV e TLG com a expressão imuno-histoquímica tecidual do GLUT-1, Ki-67, Hexokinase e Caspase-3
Keywords in Portuguese
18F-FDG uptake
Adenocarcinoma da junção esofago-gástrica
Adenocarcinoma de esôfago
Adenocarcinoma gástrico
Caspase-3
GLUT-1 12
Hexoquinase-1
Imuno-histoquímica
Ki- 67
Marcadores biológicos
Abstract in Portuguese
INTRODUÇÃO: A tomografia por emissão de pósitrons (PET/CT) tem sido extensivamente estudada nos diferentes tipos de tumores entretanto, os mecanismos celulares envolvidos na captação do 2-desoxi-2-[18F] fluoroglucose (FDG) e sua associação com o adenocarcinoma do esôfago, da junção esôfago-gástrica (JEG) e gástrico não foram completamente elucidados. OBJETIVO: O objetivo do presente estudo foi analisar a associação entre captação celular de FDG no adenocarcinoma do esôfago, da JEG e do estômago com a expressão imunohistoquímica (IH) da proteína de transporte de glicose do tipo 1 (GLUT-1), Hexokinase-1 (HK), Ki-67 e Caspase-3, marcadores do metabolismo de glicose, proliferação celular e apoptose, respectivamente. MÉTODOS: Identificaram-se retrospectivamente 26 pacientes com adenocarcinoma de esôfago, estômago e JEG confirmados histologicamente e que haviam realizado FDG-PET/CT antes do tratamento oncológico. Coletaram-se amostras de tecido tumoral de cada paciente para realização da análise IH da GLUT-1, HK, Ki-67 e Caspase-3. Verificou-se a associação da expressão IH com o valor máximo padronizado de captação (SUVmax), volume metabólico tumoral (MTV) e glicólise total da lesão (TLG). Como objetivos secundários, analisou-se a associação dos valores de SUV, MTV e TLG com o estádio TNM, dimensões do tumor, localização anatômica, subtipo histológico de Laurén, grau de diferenciação celular e com o infiltrado inflamatório tumoral. RESULTADOS: Verificou-se associação positiva entre GLUT-1 com SUVmax (p=0.001) e TLG (p=0.016), Caspase-3 com SUVmax (p=0.023), grau de inflamação com SUVmax (p=0.025) e tamanho do tumor com SUVmax (r = 0.428; p = 0.029), MTV (r = 0.661 p < 0.01) e TLG (r = 0.669 p < 0.01). Não houve associação dos parâmetros analisados com a HK e Ki-67. CONCLUSÃO: Identificou-se associação da expressão IH do GLUT-1 e Caspase-3 com a captação de FDG. A utilização do MTV e TLG possibilitou análise mais ampla dos fatores que determinam os seus valores
Title in English
FDG-PET/CT in Esophageal, gastroesophageal junction and gastric adenocarcinomas: Association analysis between SUV, MTV and TLG with GLUT-1, Ki-67, Hexokinase and Caspase-3 tissue immunohistochemistry expression
Keywords in English
18F-FDG uptake
Adenocarcinoma of the esophago-gastric junction
Biological markers
Caspase-3
Esophageal adenocarcinoma
Gastric adenocarcinoma
GLUT-1
Hexokinase-1
Immunohistochemistry
Ki- 67
Abstract in English
BACKGROUND: The cellular mechanisms involved with 2-Deoxy-2-[18F]fluoroglucose (FDG) uptake in several tumors and its use in Positron Emission Tomography - Computed Tomography (PET/CT) in oncologic practice have been extensively studied however, these cellular mechanisms needs to be better elucidated in esophageal, gastroesophageal junction (GEJ) and gastric adenocarcinoma. OBJECTIVES: The aim of the present study was to analyze the association between FDG cell uptake in esophagus, gastroesophageal junction (GEJ) and gastric adenocarcinoma with the immunohistochemical expression (IH) of glucose transport protein 1 (GLUT-1), Ki-67 , Caspase-3 and Hexokinase-1 (HK), cellular markers of glucose metabolism, cell proliferation and apoptosis, respectively. METHODS: It was retrospectively enrolled 26 patients with histologically confirmed esophageal, GEJ and gastric adenocarcinoma that have been performed FDG-PET/CT before the cancer treatment. It was collected tissue sample of each patient to perform IH analyses of GLUT-1, Ki-67, Caspase-3 and HK. It was verified the association of IH expression with maximum Standardized Uptake Value (SUVmax), Metabolic Tumor Volume (MTV) and Total Lesion Glycolysis (TLG). As a secondary objective it was analyzed the TNM staging system, tumor size, anatomical location, Lauren´s histological subtype, degree of differentiation, tumoral inflammatory infiltrate and their associations with SUV, MTV and TLG. RESULTS: It was found a positive association between GLUT-1 with SUVmax (p=0.001) and TLG (p=0.016), Caspase-3 with SUVmax (p=0.023), inflammation with SUVmax (p=0.025) and tumor size with SUVmax (r= 0.428; p = 0.029), MTV (r= 0.661 p < 0.01) and TLG (r= 0.669 p < 0.01). We didn't find any association between SUVmax, MTV and TLG with HK and Ki-67. CONCLUSION: It was identified the association between IH expression of GLUT-1 and Caspase-3 with FDG uptake. The use of MTV and TLG allowed a better analysis of the factors involved with FDG uptake
 
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Publishing Date
2021-06-25
 
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