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European Journal of Nuclear Medicine and Molecular Imaging

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07.03.2022 | Original Article

Expression of fibroblast activation protein in lung cancer and its correlation with tumor glucose metabolism and histopathology

verfasst von: Xiaohui Chen, Xinran Liu, Lijuan Wang, Wenlan Zhou, Yin Zhang, Ying Tian, Jianer Tan, Ye Dong, Lilan Fu, Hubing Wu

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 8/2022

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Abstract

Purpose

To explore the expression of fibroblast activation protein (FAP) in lung cancer (LC) and its correlation with tumor glucose metabolism and histopathology.

Methods

From June 2018 to November 2020, 73 patients with newly diagnosed LC were included. Immunohistochemical staining was used to quantify FAP expression in tumors. The histopathological type and tumor grade were determined via histopathological examination. The tumor glucose metabolism parameters and tumor maximal diameter were measured via [¹⁸F] F-FDG PET/CT. Univariate and multivariate analysis were performed to study the correlation of FAP expression levels with glucose metabolism variables and tumor histopathology.

Results

Positive FAP expression was observed in 97.3% (71/73) LC lesions, which was significantly higher than 87.7% (64/73) of [¹⁸F] F-FDG positivity observed on PET/CT (χ² = 4.818, P = 0.028). In 12 early adenocarcinomas (ADCs), only three lesions (25%) were positive for [¹⁸F] F-FDG on PET/CT; however, 10 lesions (83.3%) were positive for FAP. When FAP expression was classified into low level (scores ≤ 3) and high level (scores > 4), high FAP level was found in 80.8% tumors and low FAP level in the other 19.2% tumors. High FAP level was identified in 100.0% of squamous cell carcinomas (SCCs), 85.7% of ADCs, 66.7% (4/6) of large cell neuroendocrine carcinomas (LCNCs), and 40.0% (4/10) of small cell lung cancers (SCLCs) (P < 0.05). In non-mucinous ADC lesions, on univariate analysis, FAP expression level showed a close relationship with tumor metabolism parameters (maximal standard uptake value (SUVmax), mean standard uptake value (SUVmean), and total lesion glycolysis (TLG)), tumor diameter, tumor grade, and lesion attenuation (P < 0.05).

Conclusion

The present study demonstrates that FAP is widely expressed in LC and shows great variation in different histopathological types. A high positive rate of FAP expression implies that FAP-targeted imaging may be a sensitive modality for diagnosing LC, especially in early ADCs. Further validation with such probes is warranted.

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Titel: Expression of fibroblast activation protein in lung cancer and its correlation with tumor glucose metabolism and histopathology
verfasst von: Xiaohui Chen
Xinran Liu
Lijuan Wang
Wenlan Zhou
Yin Zhang
Ying Tian
Jianer Tan
Ye Dong
Lilan Fu
Hubing Wu
Publikationsdatum: 07.03.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 8/2022
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-022-05754-4

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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