Nucleophosmin 1 overexpression correlates with F-FDG PET/CT metabolic parameters and improves diagnostic accuracy in patients with lung adenocarcinoma.

Purpose: This study investigated the correlation of nucleophosmin 1 (NPM1) expression with F-fluorodeoxyglucose (F-FDG) positron emission tomography/computerised tomography scan (PET/CT)-related parameters and compared the diagnostic value of NPM1 with that of the positive biomarker TTF1 in lung adenocarcinoma patients.

Methods: Forty-six lung adenocarcinoma patients who underwent F-FDG PET/CT before pulmonary surgery were retrospectively analysed. Metabolic parameters including SUV, SUV, metabolic tumour volume (MTV) and total lesion glycolysis (TLG) were calculated from F-FDG PET imaging data. The expression levels of NPM1 and TTF1 were assessed using The Cancer Genome Atlas (TCGA) database and immunohistochemistry of tumour tissues and adjacent normal lung tissues. We examined the association between the frequency of NPM1 and TTF1 expression and the metabolic parameters.

Results: Lung adenocarcinoma samples expressed higher levels of NPM1 than adjacent normal lung epithelial tissues. NPM1 showed higher specificity and sensitivity for lung adenocarcinoma compared with TTF1 (p < 0.001). SUV, SUV and TLG correlated with NPM1 expression (p < 0.001). MTV was inversely correlated with TTF1 (p < 0.01). SUV was the primary predictor of NPM1 expression by lung adenocarcinoma (p < 0.01). A cutoff value for the SUV of 3.93 allowed 90.9% sensitivity and 84.6% specificity for predicting NPM1 overexpression in lung adenocarcinoma.

Conclusion: NPM1 overexpression correlated with F-FDG PET/CT metabolic parameters and improved diagnostic accuracy in lung adenocarcinoma. SUV on F-FDG PET/CT may estimate NPM1 expression for targeted therapy of lung adenocarcinoma.