Ichikawa T, Aokage K, Miyoshi T, et al. - Researchers analyzed patients (n = 50) with clinical stage IA radiological pure-solid lung adenocarcinoma, to determine if there exists a link between fluorodeoxyglucose (FDG) accumulation and expression of microenvironmental factors. The participants were assessed with 18 F-FDG PET (positron emission tomography) before operation, and their FDG–PET maximal standardized uptake values (SUVmax) were calculated. Two groups were defined: high and low SUVmax. SUVmax was identified as an independently significant prognostic factor in a multivariate analysis. The SUV max high and low groups showed a 5-year overall survival rate of 68.0% vs 100% and 5-year recurrence free survival rate of 54.3% vs 90.8%, respectively. In the SUVmax high group, significantly higher expression levels of glucose transporter type 1 and phosphorylated AKT were detected in cancer cells. This group also had significantly higher numbers of the tumor-promoting stromal cells, ie, podoplanin-positive cancer associated fibroblasts and CD204-positive tumor-associated macrophages. Among participants, a close link was evident between the SUVmax and expressions of metabolism related markers in cancer cells as well as tumor promoting markers in stromal cells.