Baseline Suvmax Correlates with Tumor Hypoxia and Patient Outcomes in Nasopharyngeal Carcinoma: Employing Transcriptomic Gene Signature Analysis

Abstract Objective: To assess the prognostic relevance of the maximum standard uptake value (Suvmax) in Nasopharyngeal carcinoma (NPC), establish a gene signature correlated with Suvmax and explore the potential biological mechanisms underlying these associations for predicting clinical outcomes. Methods: A cohort of 726 NPC patients underwent analysis to determine correlations between Suvmax and various clinical variables, including tumor stage, metabolic tumor volume (MTV), and lactate dehydrogenase (LDH) levels. RNA sequencing data was utilized to identify genes related to Suvmax, which were then used to develop a 'Suv-signature'. Additionally, transcriptome enrichment analysis was conducted to investigate the potential biological mechanisms underlying the observed correlations. Results: Higher Suvmax values were associated with increased tumor burden and worse prognosis. The 'Suv-signature' consisting of 10 genes, showed a positive correlation with Suvmax and predicted poorer survival outcomes. This signature was highly expressed in malignant epithelial cells and was associated with hypoxia and resistance to radiotherapy. Additionally, the signature showed a negative correlation with immune function. Conclusion: Suvmax is a valuable prognostic indicator in NPC, with higher values predicting worse outcomes. The 'Suv-signature' offers further prognostic insights, linking glucose metabolism to tumor aggressiveness, treatment resistance, and immune function, and may serve as a potential biomarker for NPC.