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. 2017 Feb 8:2:53-58.
doi: 10.1016/j.ctro.2017.01.003. eCollection 2017 Feb.

Glut-1 expression in small cervical biopsies is prognostic in cervical cancers treated with chemoradiation

Yada Kanjanapan  1 , Siddhartha Deb  2   3 , Richard J Young  4 , Mathias Bressel  5 , Linda Mileshkin  1   3 , Danny Rischin  1   3 , Michael S Hofman  6   3 , Kailash Narayan  7   3 , Shankar Siva  7   3
Affiliations

Glut-1 expression in small cervical biopsies is prognostic in cervical cancers treated with chemoradiation

Yada Kanjanapan et al. Clin Transl Radiat Oncol. .

Abstract

Background/purpose: Chemoradiation (CRT) is standard therapy for locally advanced cervical cancer (LACC). However, there is a lack of biomarkers to identify patients at high relapse-risk. We examine metabolic (glucose transporter-1 [Glut-1]), hypoxic (hypoxia inducible factor [HIF-1α]; carbonic anhydrase [CA-9]) and proliferative (Ki-67) markers for prognostic utility in LACC.

Materials/methods: 60 LACC patients treated with CRT had pre-treatment biopsies. Immunohistochemistry was performed for Glut-1, HIF-1a and CA-9, to generate a histoscore from intensity and percentage staining; and Ki-67 scored by percentage of positive cells. For each biomarker, treatment response and survival was compared between low and high-staining groups by logrank testing and multivariate analyses.

Results: High Glut-1 expression was associated with inferior progression-free survival (PFS), (hazard ratio [HR] 2.8, p = 0.049) and overall survival (OS), (HR 5.0, p = 0.011) on multifactor analysis adjusting for stage, node positivity, tumour volume and uterine corpus invasion. High Glut-1 correlated with increased risk of distant failure (HR 14.6, p = 0.001) but not local failure. Low Glut-1 was associated with higher complete metabolic response rate on post-therapy positron emission tomography scan (odds ratio 3.4, p = 0.048). Ki-67 was significantly associated with PFS only (HR 1.19 per 10 units increase, p = 0.033). Biomarkers for hypoxia were not associated with outcome.

Conclusions: High Glut-1 in LACC is associated with poor outcome post CRT. If prospectively validated, Glut-1 may help select patients for more intensive treatment regimens.

Keywords: Biomarker; Cervical cancer; Glut-1; Immunohistochemistry.

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Figures

Fig. 1
Fig. 1
Flow of cases through the study according to REMARK criteria.
Fig. 2
Fig. 2
Progression free survival according to Glut-1 expression (histoscore).
Fig. 3
Fig. 3
Overall survival according to Glut-1 expression (histoscore).
See this image and copyright information in PMC

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