The Correlated Investigation For Glucose Transporter-1,Sodium-Glucose Cotransporter-2 And ¹⁸F-FDG PET/CT Imaging In Non-Small Cell Lung Cancer

Objective:To measure the serum concentrations of Glut-1,SGLT2 in primary patients with non-small cell lung cancer(NSCLC)by the Enzyme-linked Immunosorbent Assay(ELISA),investigate the correlation between the expression levels of Glut-1,SGLT2 and 18F-FDG PET/CT Imaging parameters in patients of NSCLC,and to improve the efficiency of diagnosis and treatment for NSCLC patients.Methods:From October 2020 to October 2021,51 patients of NSCLC(experimental group)who were treated in our hospital and underwent 18F-FDG PET/CT Imaging in the Department of Nuclear Medicine were chosen,and their serum samples were collected.The serum samples from 40 healthy population were collected as control group in the corresponding periods.The concentrations of Glut-1,SGLT2 in serum samples of all subjects was measured by ELISA.The PET/CT imaging parameters of NSCLC patients such as the value of SUVmax,TLG and MTVwere analyzed.The relationship between expression levels of Glut-1,SGLT2 and 18F-FDG PET/CT imaging parameters were investigated in NSCLC.Results:1.The Glut-1 serum concentration of the experimental group was 1.788± 0.895 ng/ml,and that of the control group was 0.661±0.312 ng/ml;the formerwas significantly higher than that in control group(Z=-4.554,P=0.000).The serum SGLT2 concentration in the experimental group was 0.308±0.112ng/ml,and the serum SGLT2 concentration in the control group was 0.240±0.128ng/ml,there was no significant difference of the serum SGLT2 concentration in two groups(Z=-0.556,P=0.578).2.The serum Glut-1 concentration in the experimental group was moderately positive correlation with the primary tumor SUVmax(r=0.451,P=0.001)and TLG(r=0.330,P<0.05),and weakly positive correlation with diameter of the primary tumor(t=0.299,P<0.05).The serum SGLT2 concentration in the experimental group was not correlated with the value of SUVmax,TLG,MTV,and R(P>0.05).The Glut-1 concentration was positively correlated with the serum SGLT2 concentration in the experimental group(r=0.594,P<0.001).But the serum Glut-1 concentration was not correlated with serum SGLT2 concentration in control group(P>0.05).3.According to the TNM stage,pathological type and metastasis,the NSCLC patients were divided into different groups.The serum Glut-1 concentration in all group of NSCLC was higher than that in the control group(P<0.05).However,the serum SGLT2 concentration was only higher in the early-stage group of NSCLC than that in the control group(P<0.05).There were significant differences among serum Glut-1,SGLT2 concentrations and PET/CT imaging parameters except for MTV(P<0.05)among different pathological types of NSCLC,and that were significantly higher in the squamous cell carcinoma group than that in the adenocarcinoma group(P<0.05).In different stages of NSCLC,there was no difference of serum Glut-1 concentrations in early and late stages,but there was difference of serum SGLT2 concentrations,which was higher in early stage than that in late stage(P<0.05);there were differences in TLG and R between early and late stages(P<0.05).However,there were no differences of the serum Glut-1,SGLT2 concentrations and PET/CT imaging parameters between the two groups of NSCLC with or without metastasis(P>0.05).4.In the squamous cell carcinoma group,the serum Glut-1 concentration was positively correlated with the SUVmaxvalue of the primary tumor(r=0.528,P<0.05),but had not correlation with SGLT2concentration(r=0.026,P>0.05).The serum Glut-1 concentration in the adenocarcinoma group was positively correlated with SGLT2concentration(r=0.622,P<0.001),but not with the SUVmaxvalue of the primary tumor(r=0.053,P>0.05).There was no significant correlation between Glut-1 level and the value of TLG MTV and R in both group(P>0.05).According to the TNM staging,the serum Glut-1 concentration was positively correlated with SGLT2,SUVmax,TLG,and R(P<0.05)in the early group;while the serum Glut-1 concentration in the advanced group was only correlated with SGLT2 concentration and the value of SUVmax(P<0.05),and not with the value of TLG,R(P>0.05);the serum Glut-1 concentrations in both groups were not associated with the value of MTV(P>0.05).According to whether the patients had metastasis,the serum Glut-1 concentration in the non-metastatic group was positively correlated with SGLT2(P<0.05),but not with the value of SUVmax;the serum Glut-1 concentration in the metastatic group was positively correlated with SGLT2 concentration and the value of SUVmax(P<0.05);The concentration of Glut-1 had nothing to do with the value of TLG,MTV and R in both groups(P>0.05).Conclusion:1.The serum Glut-1 levels in primary NSCLC patients were significantly higher than those in healthy normal people,while SGLT2 levels were not different from healthy normal people.It is suggested that serum Glut-1 levels can be used as a reference marker for the diagnosis of non-small cell lung cancer.2.The serum Glut-1,SGLT2 concentrations and the SUVmax values of PET/CT imaging parameters were related to NSCLC pathological type,and these were significantly higher in the squamous carcinoma group than those in the adenocarcinoma group;The serumGlut-1 concentration was not related to NSCLCstaging,while SGLT2 concentration was higher in early stage than that in advanced stage.It is suggested that Glut-1 and SGLT2 can be expressed simultaneously in NSCLC and involved in its occurrenceand development.3.The Glut-1 concentration is positively correlated with the SUVmax values of PET/CT parameters,which can reflect the glucose metabolism status of NSCLC patients in some extent,and is conducive to the formulation of the treatment plan for NSCLC patients.