Relationship between FDG-PET and GLUT-1 immunostaining of primary musculoskeletal tumors.

正电子发射断层扫描（PET）可以提供一种体内方法来评估正常和病变组织的代谢和生理。[18F] 2-脱氧-2-氟-d -葡萄糖（FDG）是PET成像中最常用的放射性标记示踪剂，临床试验表明，FDG在几种癌症组织中的积累增加。最近的报道和我们自己的经验表明，FDG-PET可能不能准确反映肌肉骨骼肿瘤的恶性潜能，而是暗示病变中包含的细胞成分。在组织细胞、成纤维细胞和一些神经源性病变中，无论其是良性还是恶性，都可以观察到FDG的高积聚。在本研究项目中，我们试图比较FDG在PET研究和葡萄糖转运蛋白-1 （GLUT-1）免疫染色上对肌肉骨骼肿瘤的摄取。第一步，我们选择组织细胞肿瘤（恶性纤维组织细胞瘤、骨和肌腱鞘巨细胞瘤、非骨化纤维瘤、结节病、朗格汉斯细胞组织细胞增生症等）进行免疫组化。到目前为止，对于福尔马林固定和石蜡包埋的切片，免疫染色在技术上还不稳定。所以，最近，我们正在尝试对新鲜标本的切片进行染色。FDG在肌肉骨骼肿瘤中的摄取机制有待进一步研究，因为我们应该知道FDG- pet是否可以作为鉴别肌肉骨骼良恶性病变的筛查方法，包括许多来自不同组织的肿瘤。

Positron emission tomography (PET) can provide an in vivo method for evaluating metabolism and physiology in normal and diseased tissues. Clinical trials with [18F] 2-deoxy-2-fluoro-D-glucose (FDG), the most commonly used radiolabeled tracer for PET imaging, have demonstrated increased accumulation of FDG in several cancer tissues. Recent reports and our own experiences suggest that FDG-PET might not accurately reflect malignant potential of musculoskeletal tumors, but rather implicate cellular components included in the lesions. A high accumulation of FDG can be observed in histiocytic, fibroblastic, and some neurogenic lesions, regardless of whether they are benign or malignant.In this research project, we have tried to compare FDG uptake on PET study to glucose transporter-1 (GLUT-1) immunostaining of musculoskeletal tumors. For the first step, we have selected histiocytic tumors (malignant fibrous histiocytoma, giant cell tumor of bone and tendon sheath, non-ossifying fibroma, sarcoidosis, Langerhans cell histiocytosis, etc.) for the immunohistochemistry. So far, the immunostaining is not technically stable for formalin-fixed and paraffin-embedded sections. So, recently, we are trying the staining for sections of fresh specimens.The mechanism of FDG uptake in musculoskeletal tumors is continuously to be investigated, because we should know whether FDG-PET can be a screening method for differential diagnosis between benign and malignant musculoskeletal lesions, including many neoplasms originating from different tissues altogether.