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Preoperative High Maximum Standardized Uptake Value in Association with Glucose Transporter 1 Predicts Poor Prognosis in Pancreatic Cancer

Akira Chikamoto MD, FACS, Risa Inoue MD, Yoshiaki Komohara MD, PhD, Kentaro Sakamaki PhD, Daisuke Hashimoto MD, PhD, FACS, Shinya Shiraishi MD, PhD, Hiroshi Takamori MD, PhD, FACS, Yo-ichi Yamashita MD, PhD, FACS, Naoya Yoshida MD, PhD, FACS, Takeharu Yamanaka PhD, Yasuyuki Yamashita MD, PhD, Hideo Baba MD, PhD, FACS
Pancreatic Tumors
Volume 24, Issue 7 / July , 2017



The diagnosis of malignant diseases worldwide has been determined using 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). Glucose transporter type 1 (Glut-1) is a key protein associated with the accumulation of FDG in cancer cells. This study evaluated the relationship between Glut-1 expression and FDG accumulation to determine the usefulness of FDG-PET for prediction of long-term outcomes of pancreatic cancer.


The expression of Glut-1 was immunohistochemically examined in 138 surgically resected pancreatic cancer specimens. The Glut-1-positive and Glut-1-negative groups were analyzed with respect to their clinicopathologic characteristics and prognosis. Before surgery, 93 patients underwent FDG-PET and measurement of the corrected maximum standardized uptake value (cSUVmax). The relationship between Glut-1 expression and cSUVmax were examined, and prognostic factors were identified using uni- and multivariate analyses.


Glut-1 was positive in 69 patients (50%). The median relapse-free and overall survival times were significantly shorter in the Glut-1-positive group (11 vs. 22 months, respectively) than in the Glut-1-negative group (23 vs. 42 months, respectively). The cSUVmax was significantly associated with long-term survival. The relapse-free and overall survival rates were significantly poorer in the high-cSUVmax group than in the low-cSUVmax group. Glut-1 expression was associated with cSUVmax accumulation. In the multivariate Cox regression analysis using forward stepwise selection, male gender, positive lymph node metastases, high CA19-9, and high cSUVmax were identified as independent prognostic factors for pancreatic cancer.


A significant relationship exists between high preoperative cSUVmax and Glut-1 expression. High cSUVmax is one of the prognostic factors for overall survival after resection of pancreatic cancer.

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