[Analysis of adjuvant chemotherapy efficacy based on GLUT1 expression levels after radical resection of pancreatic cancer].

Abstract

Objective: To investigate the impact of glucose transporter 1 (GLUT1) expression levels on adjuvant chemotherapy efficacy following radical resection of pancreatic cancer and its prognostic significance. Methods: This is a retrospective cohort study. A total of 200 patients who underwent radical resection and adjuvant chemotherapy for pancreatic cancer at the First Affiliated Hospital of Naval Medical University between July 2021 and October 2023 were enrolled. There were 103 males and 97 females, with an age(M(IQR)) of 63 (13) years (range: 33 to 80 years). Tumors were located in the pancreatic head and neck in 126 cases (63.0%) and in the pancreatic body and tail in 74 cases(37.0%). Clinicopathological data and adjuvant chemotherapy regimens were collected. GLUT1 expression in tumor tissues was detected by immunohistochemistry and categorized into high-expression group and low-expression group. A 1∶1 propensity score matching (PSM) was performed to balance confounding factors between groups. Disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox proportional hazards regression model. Results: In the original cohort, both DFS and OS in the high GLUT1 expression group were significantly inferior to those in the low expression group (DFS: 13.6 months vs. 21.1 months, P<0.01;OS: 25.0 months vs. 31.4 months, P<0.01). After PSM, 71 cases were included in each group with balanced baseline characteristics (all P>0.05). Univariate and multivariate analyses revealed that high GLUT1 expression was an independent adverse prognostic factor for DFS (HR=4.742, 95%CI: 2.978 to 7.551) and OS (HR=5.042, 95%CI: 2.673 to 9.513). Subgroup analysis demonstrated that among patients receiving mFOLFIRINOX or gemcitabine-based combination regimens as adjuvant chemotherapy, both DFS and OS were significantly better in the low GLUT1 expression group compared with the high expression group (all P<0.05). Conclusion: GLUT1 expression level affects adjuvant chemotherapy efficacy after radical resection of pancreatic cancer, and its high expression is an independent adverse prognostic factor.