The Correlation Between Hypoxic Microenvironment And PET-CT SUVmax In Lung Cancer And Its Effects On Prognosis

Objective: To investigate the correlation between the PET-CT SUV max and the expression of HIF-1?,CA9,CD31 in tumor tissues of non-small cell lung cancer(NSCLC)and its effect on the prognosis of patients,so as to provide a theoretical basis for the prognosis assessment of NSCLC patients and the selection of clinical treatment plan.Plans:Clinical data of 45 NSCLC patients who underwent PET-CT examination and surgical resection in the affiliated hospital of Inner Mongolia medical university from October 2015 to April 2017 were collected,none of the patients underwent any antitumor therapy before surgery.HIF-1?,CA9,CD31 immunohistochemical staining and quantitative analysis were performed on the tumor tissue samples excised during surgery.Patients were followed up regularly after the operation to compare the relationship between HIF-1?,CA9,CD31,PET-CT,SUVmax and the prognosis of the patients.(Disease-free survival time DFS as a prognostic indicator).X2 test and T test were used to analyze the correlation between the expression level of each factor and clinical characteristics.Pearson method was used for correlation analysis,the survival of patients was analyzed by univariate and multivariate regression analysis.Result:1.There were 31 patients with stage IA,6 patients with stage IB,3 patients with stage IIA and 5 patients with stage IIB in 45 NSCLC patients.The tumor size was22.80±13.04 mm,the single-factor linear regression of tumor maximumdiameter,tumor stage was negatively correlated with DFS(P <0.001),and there was no significant correlation between pathological type,age and sex and DFS,The tumor size was negatively correlated with DFS in multivariate regression(P =0.003).2.HIF-1? expression was observed in 27patients(60%),CA9 expression was observed in 21patients(46.7%),the MVD was 28±7.57,HIF-1? and CA9 were negatively expressed in normal cells in the tumor tissue and the control group.There were positive correlations between the expression of HIF-1? and CA9(r =0.693 P<0.001).The MVD showed no association with the expression of HIF-1 or CA9(P=0.06,P =0.11).Univariate regression analysis of HIF-1?,CA9 was negatively correlated with DFS in NSCLC patients(P <0.001),and CD31 was not correlated with DFS(P =0.15).Multivariate analysis of HIF-1?,CA9 showed no correlation with DFS(P = 0.72,P =0.14).3.The median value of PET-CT SUVmax in 45 patients was 6.17.Pearson correlation analysis showed that SUVmax was correlated with HIF-1??CA9expression SUVmax(r =0.783,P<0.001)?(r =0.793,P<0.001),and CD31 showed no assosiation with SUVmax(r =0.288 P=0.06).Univariate analysis showed a significant negative correlation between SUVmax and DFS(P<0.001),while multi-factor regression analysis showed a significant negative correlation between SUVmax and DFS(P<0.001).Conclusion:The expression of HIF-1? and CA9 in NSCLC tissues can reflect the hypoxic state of the tumor and positively correlate with PET-CT SUVmax.PET-CT SUVmax may be an indicator to detect tumor hypoxia.PET-CT SUVmax is an independent risk factor for poor prognosis in NSCLC patients.