Research Of Metabolic Mechanism Of Tuberculosis On ¹⁸F-FDG PET/CT

Objective To measure the SUVmax of tuberculous granuloma in 18F-FDG PET/CT and investigate the expression of Glut-1,Glut-3 and LDHA in tuberculosis tissues,analyzing the relationship between the FDG uptake and those protein expression,interpretation 18 FFDG uptake mechanism of tuberculosis.Method The 18F-FDG maximum standard uptake(SUVmax)and the size of the tuberculosis lesion of the 28 patients were measured in 18F-FDG PET / CT.The expression of Glut-1,Glut-3 and LDHA of the tuberculosis lesion detected by immunohistochemical method,and semi-quantitative analysis was performed by manual counting.The difference in positive expression between Glut-1 and Glut-3 proteins in tuberculous granulomas was analyzed using the Wilcoxon symbol rank sum test of paired data.The relationship between the protein expression and the SUVmax was analyzed by Spearman rank correlation analysis.Result The maximal diameter of the tuberculosis lesion was 0.50 ~ 5.30 cm,mean 2.61 ± 1.40,SUVmax was 1.3 ~ 23.5,mean 8.87 ± 5.10.The score of Glut-1,Glut-3 and LDHA in tuberculous granuloma were 3.10 ± 1.51,4.36 ± 0.99,4.24 ± 1.20 respectively.The difference in the expression of Glut-1 and Glut-3 was statistically significant(u =-3.178,P = 0.001),Glut-3 expression was higher than Glut-1 expression.There were no correlation between Glut-1 and Glut-3,Glut-1 and LDHA,Glut-3 and LDHA expression in tuberculous granulation tissue(r = 0.381,0.286,0.197,P = 0.321,0.069,0.248),the expression of the three proteins was independent.There was a positive correlation between the values of SUVmax and the expression of Glut-1 Glut-3 and LDHA in tuberculosis granuloma(r = 0.438,0.615,0.481,P = 0.020,0.001,0.011).Conclusion Tuberculosis granuloma showed different SUVmax values along with the different degree of the lesion.Glut-1,Glut-3 and LDHA were expressed in tuberculosis granuloma,and the expression of Glut-1,Glut-3 and LDHA protein was positively correlated with the concentration of FDG in tuberculous granuloma.Glut-3 expression was significantly higher than Glut-1 expression.And we conclude that the mechanism of increased SUVmax in tuberculosis granuloma may be related to the increasedexpressionof Glut-1,Glut-3 and the mechanism of inflammatory cell metabolism turn to aerobic glycolysis.