Immunohistochemical overexpression of hypoxia-induced factor 1α associated with slow reduction in 18fluoro-2-deoxy-D-glucose uptake for chemoradiotherapy in patients with pharyngeal cancer

Shang Wen Chen, Ying Chun Lin, Rui Yun Chen, Te Chun Hsieh, Kuo Yang Yen, Ji An Liang, Shih Neng Yang, Yao Ching Wang, Ya Huey Chen, Nan Haw Chow, Chia Hung Kao

Research output: Contribution to journalArticlepeer-review

Abstract

Background: This study examined genomic factors associated with a reduction in 18fluoro-2-deoxy-D-glucose (FDG) uptake during positron emission tomography–computed tomography (PET-CT) for definitive chemoradiotherapy (CRT) in patients with pharyngeal cancer. Methods: The pretreatment and interim PET-CT images of 25 patients with advanced pharyngeal cancers receiving definitive CRT were prospectively evaluated. The maximum standardized uptake value (SUVmax) of the interim PET-CT and the reduction ratio of the SUVmax (SRR) between the two images were measured. Genomic data from pretreatment incisional biopsy specimens (SLC2A1, CAIX, VEGF, HIF1A, BCL2, Claudin-4, YAP1, MET, MKI67, and EGFR) were analyzed using tissue microarrays. Differences in FDG uptake and SRRs between tumors with low and high gene expression were examined using the Mann–Whitney test. Cox regression analysis was performed to examine the effects of variables on local control. Results: The SRR of the primary tumors (SRR-P) was 0.59 ± 0.31, whereas the SRR of metastatic lymph nodes (SRR-N) was 0.54 ± 0.32. Overexpression of HIF1A was associated with a high iSUVmax of the primary tumor (P < 0.001) and neck lymph node (P = 0.04) and a low SRR-P (P = 0.02). Multivariate analysis revealed that patients who had tumors with low SRR-P or high HIF1A expression levels showed inferior local control. Conclusion: In patients with pharyngeal cancer requiring CRT, HIF1A overexpression was positively associated with high interim SUVmax or a slow reduction in FDG uptake. Prospective trials are needed to determine whether the local control rate can be stratified using the HIF1A level as a biomarker and SRR-P.

Original languageEnglish
Pages (from-to)2343-2352
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume43
Issue number13
DOIs
Publication statusPublished - 2016 Dec 1

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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