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Overexpression of Glut-1 and increased glucose metabolism in tumors are associated with a poor prognosis in patients with oral squamous cell carcinoma
Article first published online: 3 FEB 2003
Copyright © 2003 American Cancer Society
Volume 97, Issue 4, pages 1015–1024, 15 February 2003
How to Cite
Kunkel, M., Reichert, T. E., Benz, P., Lehr, H.-A., Jeong, J.-H., Wieand, S., Bartenstein, P., Wagner, W. and Whiteside, T. L. (2003), Overexpression of Glut-1 and increased glucose metabolism in tumors are associated with a poor prognosis in patients with oral squamous cell carcinoma. Cancer, 97: 1015–1024. doi: 10.1002/cncr.11159
- Issue published online: 3 FEB 2003
- Article first published online: 3 FEB 2003
- Manuscript Accepted: 30 SEP 2002
- Manuscript Revised: 22 AUG 2002
- Manuscript Received: 11 JUN 2002
- Mainzer Forschungsförderungsprogramm des Fachbereichs Medizin
- National Institutes of Health. Grant Number: PO1-DE12321
- glucose transport;
- oral carcinoma;
- [18F]-2-fluoro-2 deoxy-D-glucose;
- positron emission tomography;
- Glut-1 expression
The overexpression of glucose transporters, especially of Glut-1, is a common characteristic of human malignancies, including head and neck carcinoma. Recently, the assessment of glucose metabolism in the tumor with [18F]-2-fluoro-2 deoxy-D-glucose (FDG) and positron emission tomography (FDG-PET) 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).
Retrospective analysis of Glut-1 expression was performed by immunohistology in 118 patients with OSCC, and a Glut-1 labeling index (LI) was established for each. A separate group of 44 patients with primary OSCC was evaluated prospectively by FDG-PET prior to surgery. To link the expression of Glut-1 with glucose metabolism, both FDG-PET and immunohistology were determined in a subgroup of 31 patients, and the results were correlated with overall survival.
The patients who had OSCC with a low LI for Glut-1 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 Glut-1 expression was an independent marker of prognosis in patients with OSCC. In patients who were evaluated by FDG-PET, 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 Glut-1 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 Glut-1 LI and the SUV.
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;97:1015–24. © 2003 American Cancer Society.