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. 2019 Sep 9:7:e7635.
doi: 10.7717/peerj.7635. eCollection 2019.

Correlation between 18F-FDG maximum standardized uptake value with CD147 expression in lung adenocarcinomas: a retrospective study

Fei Guo  1 , Xueyan Li  2 , Guodong Yao  3 , Guangchun Zeng  3 , Lijuan Yu  2
Affiliations

Correlation between 18F-FDG maximum standardized uptake value with CD147 expression in lung adenocarcinomas: a retrospective study

Fei Guo et al. PeerJ. .

Abstract

Background: The pro-tumoral action of the cluster of differentiation 147 (CD147), which is associated with the chemotherapy resistance of lung adenocarcinoma, is partly due to accelerated tumor cell glycolysis. 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) metabolic parameters included maximal standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), which are non-invasive markers of the glucose metabolism of tumor cells in vivo. This study aimed to clarify the correlation between PET metabolic parameters and CD147 expression, and to evaluate the prognostic value of CD147 expression in resectable lung adenocarcinoma patients.

Methods: A total of 89 lung adenocarcinoma chemotherapy-naive patients who underwent 18F-fluorodeoxyglucose positron emission tomography and computerized tomography scan before pulmonary surgery were retrospectively analyzed. The PET metabolic parameters were calculated by 18F-FDG PET imaging, and CD147 expression was analyzed by immunohistochemistry. SUVmax, SUVmean, MTV, and TLG compared for their performance in predicting the expression of CD147 were illustrated with statistical analysis. All patients were then followed-up for survival analysis.

Results: The SUVmax was significantly correlated with the CD147 expression and was the primary predictor for the CD147 expression of lung adenocarcinoma. A cut-off value of the SUVmax, 9.77 allowed 85.1% sensitivity and 64.3% specificity for predicting the CD147 positive lung adenocarcinoma. CD147 expression was correlated with tumor differentiation and metastasis. Univariate survival analysis showed that CD147 expression was significantly associated with a shorter overall survival (OS) time. Multivariate analysis revealed that CD147 was an independent prognostic factor of lung adenocarcinoma patients.

Conclusion: The SUVmax of a primary tumor measured with 18F-FDG PET may be a simple and non-invasive marker for predicting CD147 expression in lung adenocarcinoma. CD147 is an independent prognostic factor related to OS of postoperative lung adenocarcinoma patients.

Keywords: 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET); Chemotherapy resistance; Cluster of differentiation 147 (CD147); Lung adenocarcinoma; Maximal standardized uptake values (SUVmax).

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Distribution of PET metabolic parameter according to the CD147 IHC score.
(A) SUVmax, (B) SUVmean, (C) MTV, (D) TLG.
Figure 2
Figure 2. Representative images of PET-CT and immunohistochemistry.
Transaxial images of (A) diagnostic CT, (B) FDG-PET, (C) merge of PET and CT images, and (D) immunohistochemical staining for CD147 (magnification, ×400). The staining intensity was scored as 3. The percentage of positive cells was scored as 4. Finally, the CD147 IHC score was 12.
Figure 3
Figure 3. Correlation analysis between PET metabolic parameter and CD147 IHC score.
(A) and (B) The SUVmax and SUVmean showed a linear correlation with the CD147 IHC score with a correlation coefficient of 0.625 and 0.630, respectively (p < 0.01). (C) and (D) There was no significant correlation between CD147 IHC score and MTV or TLG.
Figure 4
Figure 4. Determination of the cutoff value of SUVmax by the receiver operating characteristics (ROC) curve.
The ROC curve was used to determine the optimal cutoff value of SUVmax for predicting CD147-positive lung adenocarcinoma. Area under the curve: 0.818; 95% CI: 0.733-0.903. An SUVmax of 9.77 or higher indicated that the lung adenocarcinoma was CD147-positive with a sensitivity of 85.1% and specificity of 64.3%.
Figure 5
Figure 5. Kaplan–Meier survival curve.
(A) In the entire patients, CD147-positive patients had significantly shorter overall survival than CD147-negative patients (p = 0.004). (B) In those who underwent postoperative chemotherapy, the CD147-positive patients had significantly shorter overall survival than CD147-negative patients (p = 0.045).
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Grants and funding

This work was supported by the National Science Foundation of China (No. 81671771) and the Innovation Team Project, Hainan Natural Science Foundation (No. 2018CXTD347). There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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