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Prognostic significance of bone marrow FDG uptake in patients with gynecological cancer

We investigated the prognostic significance and the underlying mechanism of increased bone marrow (BM) 2-((18)F) fluoro-2-deoxy-D-glucose as a tracer (FDG)-uptake in patients with gynecological cancer. A list of patients diagnosed with cervical, endometrial, and ovarian cancer from January 2008 to D...

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Detalles Bibliográficos
Autores principales: Shimura, Kotaro, Mabuchi, Seiji, Komura, Naoko, Yokoi, Eriko, Kozasa, Katsumi, Sasano, Tomoyuki, Kawano, Mahiru, Matsumoto, Yuri, Watabe, Tadashi, Kodama, Michiko, Hashimoto, Kae, Sawada, Kenjiro, Hatazawa, Jun, Kimura, Tadashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838412/
https://www.ncbi.nlm.nih.gov/pubmed/33500424
http://dx.doi.org/10.1038/s41598-021-81298-1
Descripción
Sumario:We investigated the prognostic significance and the underlying mechanism of increased bone marrow (BM) 2-((18)F) fluoro-2-deoxy-D-glucose as a tracer (FDG)-uptake in patients with gynecological cancer. A list of patients diagnosed with cervical, endometrial, and ovarian cancer from January 2008 to December 2014 were identified. Then, through chart reviews, 559 patients who underwent staging by FDG-positron emission tomography (PET)/computed tomography (CT) and subsequent surgical resection were identified, and their clinical data were reviewed retrospectively. BM FDG-uptake was evaluated using maximum standardized uptake value (SUVmax) and BM-to-aorta uptake ratio (BAR). As a result, we have found that increased BAR was observed in 20 (8.7%), 21 (13.0%), 21 (12.6%) of cervical, endometrial, and ovarian cancer, respectively, and was associated with significantly shorter survival. Increased BAR was also closely associated with increased granulopoiesis. In vitro and in vivo experiments revealed that tumor-derived granulocyte colony-stimulating factor (G-CSF) was involved in the underlying causative mechanism of increased BM FDG-uptake, and that immune suppression mediated by G-CSF-induced myeloid-derived suppressor cells (MDSCs) is responsible for the poor prognosis of this type of cancer. In conclusion, increased BM FDG-uptake, as represented by increased BAR, is an indicator of poor prognosis in patients with gynecological cancer.