GLUT-1

GLUT-1 is a member of the mammalian facultative glucose transporter (GLUT) family. Malignant cells commonly exhibit increased glycolytic metabolism and increased expression of glucose transport genes.

Immunohistochemical expression

There is limited expression by normal tissues: erythrocytes8, testicular germinal cells, renal tubules, perineurium8, endothelial cells of the blood-brain barrier vessels and placenta (trophoblast and capillaries).
It is expressed by a range of carcinomas, including breast, head and neck, bladder, renal cell and lung.

GLUT1 is strongly expressed in colorectal carcinomas:

	Normal colonic epithelium	0/388, 0/>807, 0/119
	Acute inflammation/regeneration without dysplasia	4/59
	Inflammatory bowel disease without dysplasia	5/7(supranuclear staining)9
	DALM	9/99
	Hyperplastic polyp	0/468
	Serrated adenoma	3/148
	Tubular adenoma	0/77, 1/448
	Tubulovillous adenoma	8/10(rare focal staining)7, 0/128
	Villous adenoma	4/128
	Adenoma NOS	16/169
	Adenoma in long standing colitis	4/59
	Adenoma not contiguous with a carcinoma	0/1710
	Adenoma contiguous with a carcinoma	4/14(mixed or membranous pattern)10
	Colorectal carcinoma	44/538, 101/1127

Diffuse GLUT1 staining (>50% of cells) is associated with metastases and a higher mortality7,8.

Malignant cells blocks prepared from body cavity effusions show positivity for GLUT-1:

	Benign effusions	5/252, 1/333, 0/254
	Malignant effusions	29/312, 19/313, 28/394

Based on studies of cell blocks, cystic squamous cell carcinoma of the head and neck stains, whereas benign cystic squamous cell lesions are negative:

	Benign cystic squamous lesions	0/85, 0/136
	Metastatic squamous cell carcinomas with cystic / liquifactive degeneration	16/165 , 14/156

Mesotheliomas show distinct linear membrane staining, with or without cytoplasmic staining.

			negative	1+	2+	3+
Reactive mesothelium			40/401
Mesothelioma	epithelioid		0/481	9/481	12/481	15/481
	biphasic	epithelioid areas	1/111	6/111	3/111	1/111
	biphasic	sarcomatoid areas	4/111	3/111	2/111	2/111
	sarcomatoid		0/11	1/11	0/11	0/11
Lung	squamous carcinoma		0/281	1/281	3/281	24/281
Lung	adenocarcinoma		2/301	11/301	6/301	11/301

Diagnostic utility

Identification of malignant cells in body cavity effusions.
Identification of malignant cells in cystic squamous cell lesion of the head and neck.
Identification of invasive malignancy in colorectal epithelial neoplasms.
A promising marker for the differentiation of benign from malignant mesothelium.

References

1 Kato Y, Tsuta K, Seki K, et al. Immunohistochemical detection of GLUT-1 can discriminate between reactive mesothelium and malignant mesothelioma. Mod Pathol 2007; 20:215-20

2 Burstein DE, Reder I, Weiser K, et al. GLUT1 glucose transporter: a highly sensitive marker of malignancy in body cavity effusions. Mod Pathol 1998; 11:392-6

3 Zimmerman RL, Goonewardene S,Fogt F Glucose transporter Glut-1 is of limited value for detecting breast carcinoma in serous effusions. Mod Pathol 2001; 14:748-51 FULL TEXT

4 Afify A, Zhou H, Howell L, et al. Diagnostic utility of GLUT-1 expression in the cytologic evaluation of serous fluids. Acta Cytol 2005; 49:621-6

5 Weiner MF, Miranda RN, Bardales RH, et al. Diagnostic value of GLUT-1 immunoreactivity to distinguish benign from malignant cystic squamous lesions of the head and neck in fine-needle aspiration biopsy material. Diagn Cytopathol 2004; 31:294-9

6 Chandan VS, Faquin WC, Wilbur DC, et al. The utility of GLUT-1 immunolocalization in cell blocks: An adjunct to the fine needle aspiration diagnosis of cystic squamous lesions of the head and neck. Cancer 2006; 108:124-8 FULL TEXT

7 Haber RS, Rathan A, Weiser KR, et al. GLUT1 glucose transporter expression in colorectal carcinoma: a marker for poor prognosis. Cancer 1998; 83:34-40 FULL TEXT

8 Younes M, Lechago LV,Lechago J. Overexpression of the human erythrocyte glucose transporter occurs as a late event in human colorectal carcinogenesis and is associated with an increased incidence of lymph node metastases. Clin Cancer Res 1996; 2:1151-4 FULL TEXT

9 Fogt F, Wellmann A, Urbanski SJ, et al. Glut-1 expression in dysplastic and regenerative lesions of the colon. Int J Mol Med 2001; 7:615-9

10 Bakiet S, O'Sullivan J, Izzuan M et al. Glut1 staining pattern in contiguous and non-contiguous colorectal adenomas and their corresponding cancers. Abstract P32, Pathological Society July 2006.

This page last revised 20.6.2007.