Japanese Journal of Clinical Oncology Advance Access originally published online on June 16, 2006
Japanese Journal of Clinical Oncology 2006 36(7):403-409; doi:10.1093/jjco/hyl043
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© 2006 Foundation for Promotion of Cancer Research
[F-18]Fluorodeoxyglucose Positron Emission Tomography Can Predict Pathological Tumor Stage and Proliferative Activity Determined by Ki-67 in Clinical Stage IA Lung Adenocarcinomas
1 Department of Thoracic Surgery and Respiratory Group, Saiseikai Central Hospital, Tokyo, 2 Department of Thoracic Surgery, Graduate School of Medicine, Kumamoto University, Kumamoto, 3 Department of Pathology, Saiseikai Central Hospital, Tokyo, 4 Nishidai Clinic, Tokyo, 5 Development in Assistive Diagnostic Technology, National Cancer Center Hospital, Tokyo and 6 Department of Surgery, Kyorin University, Mitaka, Tokyo, Japan
For all reprints and all correspondence: Hiroaki Nomori, Department of Thoracic Surgery, Graduate School of Medicine, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan; E-mail: hnomori{at}kaiju.medic.kumamoto-u.ac.jp
Received December 18, 2005; accepted April 3, 2006
Objective: To predict a malignant grade of lung cancer by fluorodeoxyglucose positron emission tomography (FDG-PET) scanning, we investigated the correlation between FDG uptake and pathological tumor stage, proliferative activities determined by Ki-67 and cyclin D1, and an alteration of p53, in clinical stage (c-stage) IA lung adenocarcinomas.
Methods: FDG-PET was performed for 71 patients with c-stage IA lung adenocarcinomas. FDG uptake was measured by a contrast ratio (CR) between the tumor and contralateral lung. Ki-67, cyclin D1 and p53 staining scores were examined by immunohistochemistry.
Results: The lesions with ground-glass opacity were found in 26 patients, and solid lesions in 45 by computed tomography. The pathological tumor stages (p-stage) were stage IA in 59 and more advanced stages in 12. The latter had significantly higher CR value than the former (P < 0.001). Patients with CR 
0.55 could be predicted to be at advanced tumor stages, with a sensitivity of 0.83 and a specificity of 0.82. The CR and staining scores of Ki-67 were significantly correlated with each other (P < 0.0001), and both the values were significantly higher in advanced tumor stages than in p-stage IA, and were also significantly higher in tumors with intratumoral lymphatic, vascular and pleural involvements than in those without such features (P < 0.05–0.0001).
Conclusions: In c-stage IA lung adenocarcinomas, the FDG uptake can predict p-stage and tumor proliferative activity determined by Ki-67. For c-stage IA lung adenocarcinomas showing CR 0.55, mediastinoscopy or neoadjuvant chemotherapy is indicated.
Key Words: positron emission tomography • lung cancer • adenocarcinoma • tumor stage • proliferative activity • tumor suppressor gene
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