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

正电子发射断层扫描(PET)为评价正常组织和病变组织的代谢和生理学提供了一种在体方法。[18F]2-脱氧-2-氟-D-葡萄糖(FDG)是PET成像最常用的放射性标记示踪剂，临床试验表明FDG在几种癌症组织中积聚增加。最近的报道和我们自己的经验表明，FDG-PET可能不能准确地反映肌肉骨骼肿瘤的恶性潜能，而是涉及到病变中包括的细胞成分。在组织细胞、成纤维细胞和一些神经源性病变中可以观察到FDG的高度积聚，无论它们是良性还是恶性的。在这项研究中，我们试图将PET研究中的FDG摄取与肌肉骨骼肿瘤的葡萄糖转运蛋白-1(GLUT-1)免疫染色进行比较。对于第一步，我们选择了组织细胞瘤(恶性纤维组织细胞瘤、骨和腱鞘巨细胞瘤、非骨化性纤维瘤、结节病、朗格汉斯细胞组织细胞增生症等)。做免疫组织化学检查。到目前为止，福尔马林固定和石蜡包埋切片的免疫染色在技术上并不稳定。因此，最近，我们正在尝试新鲜标本的切片染色。肌肉骨骼肿瘤摄取FDG的机制仍有待继续研究，因为我们应该知道FDG-PET是否可以作为鉴别良恶性肌肉骨骼病变的筛查方法，包括许多肿瘤共同起源于不同的组织。

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.