摘要
目的通过比较非低黏附与低黏附性胃癌在18F FDG-PET/CT摄取率、生化指标及糖脂代谢相关基因表达上的差异,探索低黏附性胃癌存在通过脂肪酸代谢获取能量的可能性。方法回顾性分析2013年1月至2021年12月接受PET/CT检查的94例胃癌患者的临床资料,按照WHO分型分为低黏附性癌(n=28例)和非低黏附性癌(n=66例)。应用SPSS 25.0统计软件进行数据分析,两组间计量资料采用t检验或Mann-Whitney U检验;计数资料采用χ^(2)检验;采用Kaplan-Meier生存曲线分析两组间总生存期(OS)的差异。P<0.05表示差异有统计学意义。结果低黏附癌组患者的标准化摄取平均值(SUVmean)显著低于非低黏附性癌组(P=0.049),载脂蛋白AI和高密度脂蛋白显著高于非低黏附组(P<0.05);Kaplan-Meier曲线显示低黏附性癌组患者OS显著低于非低黏附组(P=0.016)。免疫组织化学染色(IHC)检测低黏附性癌组织中白细胞分化抗原36(CD36)和脂肪酸结合蛋白4(FABP4)表达显著高于非低黏附性癌(P<0.05),葡萄糖转运蛋白1(GLUT1)显著低于非低黏附性癌(P=0.033);单因素和多因素COX回归分析显示SUVmean值低(<3.25 vs.≥3.25,HR=4.7,P=0.004)、低黏附性癌(HR=5.1,P=0.031)、分期晚(IV期,HR=10.7,P=0.010)和肿瘤体积大(≥5 cm vs.<5 cm,HR=5.6,P=0.041)是影响患者OS的独立危险因素。结论低黏附性胃癌患者的糖代谢相关基因表达显著低于非低黏附性胃癌,脂代谢相关基因表达显著高于非低黏附性胃癌,同时伴随血清中载脂蛋白AI以及高密度脂蛋白显著升高。由于SUVmean显著低于非低黏附性癌,往往导致在PET/CT检查过程中不显影。
Objective By comparing the differences of 18F FDG-PET/CT uptake rate,biochemical indexes and expression of genes related to glucose and lipid metabolism between non-low adhesion and low adhesion gastric cancer,the possibility of low adhesion gastric cancer obtaining energy through fatty acid metabolism was explored.Methods The clinical data of 94 patients with gastric cancer WHO received PET/CT examination from January 2013 to December 2021 were retrospectively analyzed.According to WHO classification,they were divided into low adhesion cancer(n=28 cases)and non-low adhesion cancer(n=66 cases).SPSS 25.0 statistical software was used for data analysis,and the measurement data between the two groups were measured by t test or Mann-WhitneyU test.The statistical data were measured byχ^(2)test.Kaplan-Meier survival curve was used to analyze the difference in overall survival(OS)between the two groups.P<0.05 indicated that the difference was statistically significant.Results The standardized mean uptake(SUVmean)of low-adhesion carcinoma group was significantly lower than that of non-low-adhesion carcinoma group(P=0.049),and apolipoprotein AI and high-density lipoprotein were significantly higher than those of non-low-adhesion carcinoma group(P<0.05).Kaplan-Meier curve showed that OS in the low adhesion group was significantly lower than that in the non-low adhesion group(P=0.016).The expression of leukocyte differentiation antigen 36(CD36)and fatty acid binding protein 4(FABP4)in low-adhesion carcinoma was significantly higher than that in non-low-adhesion carcinoma(P<0.05),and glucose transporter 1(GLUT1)was significantly lower than that in non-low-adhesion carcinoma(P=0.033).Univariate and multivariate COX regression analysis showed low SUVmean value(<3.25 vs.≥3.25,HR=4.7,P=0.004),low adhesion cancer(HR=5.1,P=0.031),late stage(stage IV,HR=10.7,P=0.010)and tumor size(≥5 cm vs.<5 cm,HR=5.6,P=0.041)were independent risk factors for OS.Conclusion The expression of genes related to glucose metabolism in patients with low adhesion gastric cancer was significantly lower than that of non-low adhesion gastric cancer,and the expression of genes related to lipid metabolism was significantly higher than that of non-low adhesion gastric cancer,and the serum apolipoprotein AI and high-density lipoprotein were significantly increased in patients with low adhesion gastric cancer.Because SUVmean is significantly lower than non-low-adhesion cancers,it often results in non-development during PET/CT examination.
作者
浦凌宵
诸俊浩
陶亮
王峰
王萌
管文贤
Pu Lingxiao;Zhu Junhao;Tao Liang;Wang Feng;Wang Meng;Guan Wenxian(Department of General Surgery,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing Jiangsu Province 210008,China;Department of General Surgery,Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine,Nanjing Jiangsu Province 210008,China)
出处
《中华普外科手术学杂志（电子版）》
2024年第3期255-260,共6页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
国家自然科学基金(82203578)
南京市医药卫生科研课题(YKK20056)。
关键词
胃肿瘤
正电子发射断层显像术
糖类代谢
脂类代谢
白细胞分化抗原36
脂肪酸结合蛋白4
葡萄糖转运蛋白1
Stomach Neoplasms
Positron-Emission Tomography
Carbohydrate Metabolism
Lipid Metabolism
Leukocyte Differentiation Antigen 36
Fatty Acid Binding Protein 4
Glucose Transporter 1
作者简介
通信作者:管文贤,Email:guan_wenxian@sina.com;通信作者:王萌,Email:wangmeng1980@nju.edu.cn;共同第一作者:浦凌宵;共同第一作者:诸俊浩。
