Fluorodeoxyglucose uptake in laryngeal carcinoma is associated with the expression of glucose transporter-1 and hypoxia-inducible-factor-1α and the phosphoinositide 3-kinase/protein kinase B pathway

High fluorodeoxyglucose (FDG) uptake by human carcinomas, including head and neck cancers, is associated with a poor prognosis. Glucose transporter‑1 (Glut‑1) is believed to be an intrinsic marker of hypoxia in malignant tumors. The expression of hypoxia‑inducible factor‑1α (HIF‑1α) and correlated target genes, including Glut‑1, is regulated by the phosphoinositide 3‑kinase/protein kinase B (PI3K/Akt) pathway. However, it remains unclear whether the PI3K/Akt signaling pathway is involved in regulating FDG uptake directly. In the present study, 24 consecutive patients with laryngeal carcinoma were examined pre‑operatively and the standardized uptake values (SUV) of the laryngeal carcinomas were determined. Glut‑1, HIF‑1α, PI3K and phosphorylated‑Akt (p‑Akt) expression was detected by immunohistochemical staining of paraffin sections from the tumor specimens. Associations among SUVmax, Glut‑1, HIF‑1α, PI3K and p‑Akt protein expression and the other clinical parameters were analyzed. The univariate analyses revealed a significantly shorter survival time along with higher HIF‑1α (P=0.018) and PI3K (P=0.008) expression, but the survival time was not significantly correlated with Glut‑1 or p‑Akt expression. The multivariate analysis demonstrated that higher SUVmax (P=0.043) and PI3K expression (P=0.012) were significantly correlated with a poor survival time. Spearman's rank analysis showed significant correlations between SUVmax and HIF‑1α (r=0.577; P=0.003), PI3K (r=1.0; P<0.0001) and p‑Akt (r=0.577; P=0.003) expression. PI3K was associated with poorly‑ and moderately‑differentiated laryngeal carcinoma (P=0.012). In conclusion, a high SUVmax indicates a poor prognosis for laryngeal carcinoma. Also, a high SUVmax may be associated with the increased expression of Glut‑1, HIF‑1α, PI3K and p‑Akt.