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Abstract
The clinical significance of physiologic Fluorine-18-fluorodeoxyglucose (18F-FDG) intestinal uptake (IU) based on the predicted link with gut microbiota dysbiosis and inflammatory cytokine production was investigated in a cohort of breast cancer patients. A total of 114 patients were visually classified into the lower or higher IU group. The maximum and mean standardized uptake values of total bowel (TB SUVmax and TB SUVmean) were measured. The gut microbial abundance of the Citrobacter genus of the Enterobacteriaceae family showed a significant positive correlation with TB SUVmax and TB SUVmean (q = 0.021 and q = 0.010). The unclassified Ruminococcaceae showed a significant negative correlation with TB SUVmax (q = 0.010). The level of tumor necrosis factor alpha (TNF-α) was significantly increased in the high IU group (p = 0.017). The TNF-α levels showed a significant positive correlation with TB SUVmax (rho = 0.220 and p = 0.018) and TB SUVmean (rho = 0.250 and p = 0.007). Therefore, our findings suggest that the physiologic intestinal uptake may reflect subclinical inflammation and differences in the composition of the gut microbiome in breast cancer patients.

(좌측) 18F-FDG 장섭취가 높을수록 Citrobacter 속 (genus) 박테리아의 비율 (abundance)가 증가하였다. Citrobacter 균은 그람음성균의 일종으로서 기회감염을 통해 bacteremia까지 일으킬 수 있는 것으로 알려져 있으며, 특히 Citrobacter 속 중 C. freundi는 장관 내 염증을 일으켜서 설사와 복막염 원인 균주로 알려져 있다.

(우측) 18F-FDG 장섭취가 높을수록 unclassified Ruminococcaceae 비율이 감소하였다. Ruminococcaceae 는 butyrate 생산 균주 중 하나로써, butyrate 생산 균주들은 건강한 장내 환경을 유지하는 역할을 하는 것으로 알려져 있다.

Author information

Yoon HJ1, Kim HN2,3, Bang JI1, Lim W4, Moon BI4, Paik NS4, Kim BS5, Kim HL6.
1
Department of Nuclear Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
2
Medical Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
3
Department of Clinical Research Design and Evaluations, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
4
Department of Surgery, School of Medicine, Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea.
5
Department of Nuclear Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea. kbomsahn@ewha.ac.kr.
6
Department of Biochemistry, Ewha Womans University, School of Medicine, Seoul, Republic of Korea. hyung@ewha.ac.kr.