Changes in metabolic activity in tumor cells is one of the hallmarks of cancer. Cancer cells exhibit the Warburg effect with high glucose consumption for their energy needs. This provides the basis for imaging using 18F-2-deoxy-D-glucose for positron emission tomography to assess tumor burden and response to therapy. We postulated that metabolically active tumors may compete with the brain for glucose uptake and evaluated glucose uptake in the brain and liver in patients with multiple myeloma in various states of response and relapse. The ratio of brain to liver glucose activity (B2LR) mirrors disease activity in myeloma, predicts the presence of extramedullary disease and is also predictive of a short response to chimeric antigen receptor T cell therapy. Patients with a low B2LR also have an inferior survival compared to patients with persistently higher B2LR values. Our simple metabolic ratio has prognostic implications in myeloma and other tumors.
肿瘤细胞代谢活动的变化是癌症的显著特征之一。癌细胞表现出瓦博格效应，即通过高葡萄糖消耗满足其能量需求。这为利用18F-2-脱氧-D-葡萄糖进行正电子发射断层扫描成像提供了基础，以评估肿瘤负荷及治疗反应。我们推测代谢活跃的肿瘤可能与大脑竞争葡萄糖摄取，并在不同反应及复发状态的多发性骨髓瘤患者中评估了脑部与肝脏的葡萄糖摄取情况。脑肝葡萄糖活性比（B2LR）可反映骨髓瘤的疾病活动度，预测髓外疾病的存在，并能预示对嵌合抗原受体T细胞疗法的短期反应。与持续较高B2LR值的患者相比，低B2LR患者的生存期更短。我们提出的这一简易代谢比值对骨髓瘤及其他肿瘤具有预后提示意义。
The ratio of brain to liver glucose activity and disease activity in multiple myeloma
肿瘤(癌症)患者之家