Research Article
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Evaluation of metabolic parameters of microsatellites stable and instable colorectal cancer patients via PET/CT

Year 2024, Volume: 5 Issue: 2, 124 - 128, 30.04.2024
https://doi.org/10.47582/jompac.1462904

Abstract

Aims: Microsatellite instability has been determined as an important indicator in selecting chemotherapy drugs in colorectal cancer. Within the scope of this research, we aimed to elucidate the pathology reports and determine whether the metabolic parameters detected by PET/CT differ in MSI-positive and negative patients.
Methods: A total of 35 patients were analyzed retrospectively. The patient population consisted of patients who applied to the Nuclear Medicine Department with a diagnosis of colon or rectum cancer, underwent PET/CT imaging for staging purposes, and were operated on.
Results: A total of 35 colon or rectum cancer patients were included in this retrospective analysis. When microsatellite instability was analyzed among the patients, it was found that female patients comprised 4 microsatellite instability-positive and 16 microsatellite instability-negative individuals. On the other hand, 5 of the males were microsatellite instability positive, and 10 were microsatellite instability negative. The mean SUVmax value was 16.4±8.2, SUVmean was 8.1±1.9, TLG was 392.4±520.8, and MTV was 26.5±25.4 in the microsatellite instability-positive individuals. On the other hand, the mean SUVmax value
was 22.7±9.7, SUVmean was 5.2±2.2, TLG was 316.4±325.7, and MTV was 21.7±21.7 in the microsatellite instability-negative individuals.
Conclusion: With the advancement of image analysis technology, MTV, and TLG, volumetric indexes derived from 18F-FDG PET have been proposed for risk stratification of cancer patients. Regarding the outcomes of this research, the semiquantitative and metabolic parameters obtained by PET/CT are not different in colorectal cancer cases with instable and stable microsatellites.

References

  • 1. Ionescu VA, Gheorghe G, Bacalbasa N, Chiotoroiu AL, Diaconu C. Colorectal cancer: from risk factors to oncogenesis. Medicina. 2023;59(9):1646. doi: 10.3390/medicina59091646
  • 2. Ros J, Baraibar I, Saoudi N, et al. Immunotherapy for colorectal cancer with high microsatellite instability: the ongoing search for biomarkers. Cancers. 2023;15(17):4245. doi: 10.3390/cancers15174245
  • 3. Greco L, Rubbino F, Dal Buono A, Laghi L. Microsatellite instability and ımmune response: from microenvironment features to therapeutic actionability-lessons from colorectal cancer. Genes. 2023;14(6):1169. doi: 10.3390/genes14061169
  • 4. Dasanu CA, Alani M, Habibi S, Codreanu I. Immune checkpoint inhibition in advanced colorectal cancer with inherited and acquired microsatellite instability: current state and future directions. J Oncol Pharm Pract. 2023:10781552231178293. doi: 10.1177/10781552231178293
  • 5. Zhang L, Lu X, Xu Y, et al. Tumor-associated macrophages confer colorectal cancer 5-fluorouracil resistance by promoting MRP1 membrane translocation via an intercellular CXCL17/CXCL22-CCR4-ATF6-GRP78 axis. Cell Death Dis. 2023;14(9):582. doi: 10.1038/s41419-023-06108-0
  • 6. Zhu J, Lian J, Xu B, et al. Neoadjuvant immunotherapy for colorectal cancer: right regimens, right patients, right directions? Front Immunol. 2023;14:1120684. doi: 10.3389/fimmu.2023.1120684
  • 7. Rasilla JM. 18F-FDG PET-CT in colorectal cancer. Where are we going? Rev Esp Med Nucl Imagen Mol. 2023;42(3):137-138. doi: 10.1016/j.remnie.2023.04.006
  • 8. Cha J, Kim H, Shin HJ, et al. Does high [18F]FDG uptake always mean poor prognosis? Colon cancer with high-level microsatellite instability is associated with high [18F]FDG uptake on PET/CT. Eur Radiol. 2023;33(11):7450-7460. doi: 10.1007/s00330-023-09832-5
  • 9. Song J, Li Z, Yang L, Wei M, Yang Z, Wang X. Metabolic activity via 18F-FDG PET/CT is predictive of microsatellite instability status in colorectal cancer. BMC Cancer. 2022;22(1):808. doi: 10.1186/ s12885-022-09871-z
  • 10. Zhang L, Liu Y, Ding Y, et al. Predictive value of intratumoral-metabolic heterogeneity derived from 18F-FDG PET/CT in distinguishing microsatellite instability status of colorectal carcinoma. Front Oncol. 2023;13:1065744. doi: 10.3389/fonc. 2023.1065744
  • 11. Li J, Yang Z, Xin B, et al. Quantitative prediction of microsatellite instability in colorectal cancer with preoperative PET/CT-based radiomics. Front Oncol. 2021;11:702055. doi: 10.3389/fonc.2021.702055
  • 12. Kuhlman TE. Repetitive DNA regulates gene expression. Science. 2023;381(6664):1289-1290. doi: 10.1126/science.adk2055
  • 13. Desir AD, Ali FG. Microsatellite instability in colorectal cancer: the evolving role of immunotherapy. Dis Colon Rectum. 2023;66(10):1303-1307. doi: 10.1097/DCR.0000000000003017
  • 14. Mei WJ, Mi M, Qian J, Xiao N, Yuan Y, Ding PR. Clinicopathological characteristics of high microsatellite instability/mismatch repair-deficient colorectal cancer: a narrative review. Front Immunol. 2022;13:1019582. doi: 10.3389/fimmu.2022.1019582
  • 15. Maratt JK, Stoffel E. Identification of Lynch syndrome. Gastrointest Endosc Clin N Am. 2022;32(1):45-58. doi: 10.1016/j.giec.2021.09.002
  • 16. Smyrk TC, Watson P, Kaul K, Lynch HT. Tumor-infiltrating lymphocytes are a marker for microsatellite instability in colorectal carcinoma. Cancer. 2001;91(12):2417-2422.
  • 17. Kim ST, Cristescu R, Bass AJ, et al. Comprehensive molecular characterization of clinical responses to PD-1 inhibition in metastatic gastric cancer. Nat Med. 2018;24(9):1449-1458. doi: 10.1038/s41591-018-0101-z
  • 18. Nolano A, Medugno A, Trombetti S, et al. Hereditary colorectal cancer: state of the art in Lynch syndrome. Cancers. 2022;15(1):75. doi: 10.3390/cancers15010075
  • 19. Cortes-Ciriano I, Lee S, Park WY, Kim TM, Park PJ. A molecular portrait of microsatellite instability across multiple cancers. Nat Commun. 2017;8(1):15180. doi: 10.1038/ncomms15180
  • 20. Evrard C, Tachon G, Randrian V, Karayan-Tapon L, Tougeron D. Microsatellite instability: diagnosis, heterogeneity, discordance, and clinical ımpact in colorectal cancer. Cancers. 2019;11(10):1567. doi: 10.3390/cancers11101567
  • 21. Samstein RM, Chan TA. Dissecting microsatellite instability in colorectal cancer: one size does not fit all. Genome Med. 2017;9(1):45. doi: 10.1186/s13073-017-0438-9
  • 22. Kleiner S, Weber W. Importance of FDG-PET/computed tomography in colorectal cancer. Radiologe. 2019;59(9):812-819. doi: 10.1007/s00117-019-00584-2
  • 23. Chung HW, Lee SY, Han HS, et al. Gastric cancers with microsatellite instability exhibit high fluorodeoxyglucose uptake on positron emission tomography. Gastric Cancer. 2013;16(2):185-192. doi: 10.1007/s10120-012-0165-2
  • 24. Liu H, Ye Z, Yang T, et al. Predictive value of metabolic parameters derived from 18F-FDG PET/CT for microsatellite instability in patients with colorectal carcinoma. Front Immunol. 2021;12:724464. doi: 10.3389/fimmu.2021.724464
  • 25. Jenkins MA, Hayashi S, O’Shea AM, et al. Pathology features in Bethesda guidelines predict colorectal cancer microsatellite instability: a population-based study. Gastroenterol. 2007;133(1):48-56. doi: 10.1053/j.gastro.2007.04.044
  • 26. Jiang H, Zhang R, Jiang H, et al. Retrospective analysis of the prognostic value of PD-L1 expression and 18F-FDG PET/CT metabolic parameters in colorectal cancer. J Cancer. 2020;11(10):2864-2873. doi: 10.7150/jca.38689
  • 27. Wu J, Lv Y, Wang N, et al. The value of single-source dual-energy CT imaging for discriminating microsatellite instability from microsatellite stability human colorectal cancer. Eur Radiol. 2019;29(7):3782-3790. doi: 10.1007/s00330-019-06144-5

Kolorektal kanserde mikrosatellit stabil ve instabil hastaların PET/CT metabolik parametreleri arasındaki farkın değerlendirilmesi

Year 2024, Volume: 5 Issue: 2, 124 - 128, 30.04.2024
https://doi.org/10.47582/jompac.1462904

Abstract

ÖZET

Amaç: Mikrosatellit instabilitesi kolorektal kanserde kemoterapi ilaçlarının seçiminde önemli bir gösterge olarak belirlenmiştir. Bu araştırma kapsamında MSI pozitif ve negatif hastalarda patoloji raporlarının aydınlatılması ve PET/BT ile tespit edilen metabolik parametrelerin farklılık gösterip göstermediğinin belirlenmesi amaçlandı.


Yöntem: Toplam 35 hasta retrospektif olarak incelendi. Hasta popülasyonunu Nükleer Tıp Anabilim Dalı'na kolon veya rektum kanseri tanısıyla başvuran, evreleme amacıyla PET/BT görüntülemesi yapılan ve ameliyat edilen hastalardan oluştu.


Bulgular: Bu retrospektif analize toplam 35 kolon veya rektum kanseri hastası dahil edildi. Hastalar arasında mikrosatellit instabilitesi incelendiğinde, kadın hastaların 4'ünün mikrosatellit instabilitesi pozitif, 16'sının ise mikrosatellit instabilitesi negatif bireyden oluştuğu görüldü. Öte yandan erkeklerin 5'i mikro uydu kararsızlığı pozitif, 10'u ise mikro uydu kararsızlığı negatifti. Mikrosatellit instabilitesi pozitif olan bireylerde ortalama SUVmax değeri 16,4±8,2, SUVort değeri 8,1±1,9, TLG 392,4±520,8 ve MTV 26,5±25,4 olarak belirlendi. Mikrosatellit instabilitesi negatif olan bireylerde ise ortalama SUVmax değeri 22,7±9,7, SUVmean değeri 5,2±2,2, TLG 316,4±325,7 ve MTV 21,7±21,7 olarak belirlendi.

Sonuç: Görüntüleme analiz teknolojisinin, MTV ve TLG'nin gelişmesiyle birlikte, kanser hastalarının risk sınıflandırması için 18F-FDG PET'ten türetilen hacimsel indeksler önerilmiştir. Bu araştırmanın sonuçlarına göre, instabil ve stabil mikrosatellitlere sahip kolorektal kanser vakalarında PET/BT ile elde edilen yarı kantitatif ve metabolik parametreler farklı değildir.

References

  • 1. Ionescu VA, Gheorghe G, Bacalbasa N, Chiotoroiu AL, Diaconu C. Colorectal cancer: from risk factors to oncogenesis. Medicina. 2023;59(9):1646. doi: 10.3390/medicina59091646
  • 2. Ros J, Baraibar I, Saoudi N, et al. Immunotherapy for colorectal cancer with high microsatellite instability: the ongoing search for biomarkers. Cancers. 2023;15(17):4245. doi: 10.3390/cancers15174245
  • 3. Greco L, Rubbino F, Dal Buono A, Laghi L. Microsatellite instability and ımmune response: from microenvironment features to therapeutic actionability-lessons from colorectal cancer. Genes. 2023;14(6):1169. doi: 10.3390/genes14061169
  • 4. Dasanu CA, Alani M, Habibi S, Codreanu I. Immune checkpoint inhibition in advanced colorectal cancer with inherited and acquired microsatellite instability: current state and future directions. J Oncol Pharm Pract. 2023:10781552231178293. doi: 10.1177/10781552231178293
  • 5. Zhang L, Lu X, Xu Y, et al. Tumor-associated macrophages confer colorectal cancer 5-fluorouracil resistance by promoting MRP1 membrane translocation via an intercellular CXCL17/CXCL22-CCR4-ATF6-GRP78 axis. Cell Death Dis. 2023;14(9):582. doi: 10.1038/s41419-023-06108-0
  • 6. Zhu J, Lian J, Xu B, et al. Neoadjuvant immunotherapy for colorectal cancer: right regimens, right patients, right directions? Front Immunol. 2023;14:1120684. doi: 10.3389/fimmu.2023.1120684
  • 7. Rasilla JM. 18F-FDG PET-CT in colorectal cancer. Where are we going? Rev Esp Med Nucl Imagen Mol. 2023;42(3):137-138. doi: 10.1016/j.remnie.2023.04.006
  • 8. Cha J, Kim H, Shin HJ, et al. Does high [18F]FDG uptake always mean poor prognosis? Colon cancer with high-level microsatellite instability is associated with high [18F]FDG uptake on PET/CT. Eur Radiol. 2023;33(11):7450-7460. doi: 10.1007/s00330-023-09832-5
  • 9. Song J, Li Z, Yang L, Wei M, Yang Z, Wang X. Metabolic activity via 18F-FDG PET/CT is predictive of microsatellite instability status in colorectal cancer. BMC Cancer. 2022;22(1):808. doi: 10.1186/ s12885-022-09871-z
  • 10. Zhang L, Liu Y, Ding Y, et al. Predictive value of intratumoral-metabolic heterogeneity derived from 18F-FDG PET/CT in distinguishing microsatellite instability status of colorectal carcinoma. Front Oncol. 2023;13:1065744. doi: 10.3389/fonc. 2023.1065744
  • 11. Li J, Yang Z, Xin B, et al. Quantitative prediction of microsatellite instability in colorectal cancer with preoperative PET/CT-based radiomics. Front Oncol. 2021;11:702055. doi: 10.3389/fonc.2021.702055
  • 12. Kuhlman TE. Repetitive DNA regulates gene expression. Science. 2023;381(6664):1289-1290. doi: 10.1126/science.adk2055
  • 13. Desir AD, Ali FG. Microsatellite instability in colorectal cancer: the evolving role of immunotherapy. Dis Colon Rectum. 2023;66(10):1303-1307. doi: 10.1097/DCR.0000000000003017
  • 14. Mei WJ, Mi M, Qian J, Xiao N, Yuan Y, Ding PR. Clinicopathological characteristics of high microsatellite instability/mismatch repair-deficient colorectal cancer: a narrative review. Front Immunol. 2022;13:1019582. doi: 10.3389/fimmu.2022.1019582
  • 15. Maratt JK, Stoffel E. Identification of Lynch syndrome. Gastrointest Endosc Clin N Am. 2022;32(1):45-58. doi: 10.1016/j.giec.2021.09.002
  • 16. Smyrk TC, Watson P, Kaul K, Lynch HT. Tumor-infiltrating lymphocytes are a marker for microsatellite instability in colorectal carcinoma. Cancer. 2001;91(12):2417-2422.
  • 17. Kim ST, Cristescu R, Bass AJ, et al. Comprehensive molecular characterization of clinical responses to PD-1 inhibition in metastatic gastric cancer. Nat Med. 2018;24(9):1449-1458. doi: 10.1038/s41591-018-0101-z
  • 18. Nolano A, Medugno A, Trombetti S, et al. Hereditary colorectal cancer: state of the art in Lynch syndrome. Cancers. 2022;15(1):75. doi: 10.3390/cancers15010075
  • 19. Cortes-Ciriano I, Lee S, Park WY, Kim TM, Park PJ. A molecular portrait of microsatellite instability across multiple cancers. Nat Commun. 2017;8(1):15180. doi: 10.1038/ncomms15180
  • 20. Evrard C, Tachon G, Randrian V, Karayan-Tapon L, Tougeron D. Microsatellite instability: diagnosis, heterogeneity, discordance, and clinical ımpact in colorectal cancer. Cancers. 2019;11(10):1567. doi: 10.3390/cancers11101567
  • 21. Samstein RM, Chan TA. Dissecting microsatellite instability in colorectal cancer: one size does not fit all. Genome Med. 2017;9(1):45. doi: 10.1186/s13073-017-0438-9
  • 22. Kleiner S, Weber W. Importance of FDG-PET/computed tomography in colorectal cancer. Radiologe. 2019;59(9):812-819. doi: 10.1007/s00117-019-00584-2
  • 23. Chung HW, Lee SY, Han HS, et al. Gastric cancers with microsatellite instability exhibit high fluorodeoxyglucose uptake on positron emission tomography. Gastric Cancer. 2013;16(2):185-192. doi: 10.1007/s10120-012-0165-2
  • 24. Liu H, Ye Z, Yang T, et al. Predictive value of metabolic parameters derived from 18F-FDG PET/CT for microsatellite instability in patients with colorectal carcinoma. Front Immunol. 2021;12:724464. doi: 10.3389/fimmu.2021.724464
  • 25. Jenkins MA, Hayashi S, O’Shea AM, et al. Pathology features in Bethesda guidelines predict colorectal cancer microsatellite instability: a population-based study. Gastroenterol. 2007;133(1):48-56. doi: 10.1053/j.gastro.2007.04.044
  • 26. Jiang H, Zhang R, Jiang H, et al. Retrospective analysis of the prognostic value of PD-L1 expression and 18F-FDG PET/CT metabolic parameters in colorectal cancer. J Cancer. 2020;11(10):2864-2873. doi: 10.7150/jca.38689
  • 27. Wu J, Lv Y, Wang N, et al. The value of single-source dual-energy CT imaging for discriminating microsatellite instability from microsatellite stability human colorectal cancer. Eur Radiol. 2019;29(7):3782-3790. doi: 10.1007/s00330-019-06144-5
There are 27 citations in total.

Details

Primary Language English
Subjects Nuclear Medicine
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Şadiye Altun Tuzcu 0000-0003-3326-5358

İlbey Erkin Çetin 0009-0000-8199-6214

Fatih Güzel 0000-0002-8571-3418

Erdal Çetinkaya 0009-0001-0745-5791

Bekir Taşdemir 0000-0002-7787-0341

Hüseyin Büyükbayram 0000-0002-7168-1507

Publication Date April 30, 2024
Submission Date April 1, 2024
Acceptance Date April 22, 2024
Published in Issue Year 2024 Volume: 5 Issue: 2

Cite

AMA Altun Tuzcu Ş, Çetin İE, Güzel F, Çetinkaya E, Taşdemir B, Büyükbayram H. Evaluation of metabolic parameters of microsatellites stable and instable colorectal cancer patients via PET/CT. J Med Palliat Care / JOMPAC / jompac. April 2024;5(2):124-128. doi:10.47582/jompac.1462904

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Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]



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