PD-L1 in Lung Adenocarcinoma: Insights into the Role of 18F-FDG PET/CT
PD-L1 in Lung Adenocarcinoma: Insights into the Role of 18F-FDG PET/CT
复制标题
PD-L1 在肺腺癌中：深入了解 18F-FDG PET/CT 的作用
DOI：
10.2147/cmar.s256871
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发表时间：
2020-01-01
影响因子：
3.3
通讯作者：
Li, Yaming
中科院分区：
文献类型：
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作者：
Cui, Yan;Li, Xuena;Li, Yaming
目的探讨18氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）在肺腺癌患者肿瘤程序性死亡配体1（PD-L1）表达中的作用及其在不同PD-L1状态下的预后意义。方法回顾性分析73例原发性肺腺癌患者的18F-FDG PET/CT检查结果。评估肿瘤PD-L1、程序性死亡-1（PD-1）和葡萄糖代谢参数的表达。结果肿瘤PD-L1表达与最大标准摄取值（SUVmax）、总病变糖酵解（TLG）、己糖激酶II（HK-II）和葡萄糖转运蛋白1（GLUT-1）呈正相关（均P<0.0001）。SUVmax是肿瘤PD-L1表达的唯一独立预测因子，最佳临界值为9.5。对于所有患者，肿瘤分期SUVmax（P= 0.009）是无病生存期（DFS）/无进展生存期（PFS）的独立预后指标，CEA（P=0.003）、Ki 67（P=0.042）、PD-L1（P=0.048）和TLG（P=0.004）是总生存期（OS）的独立预后指标。肿瘤分期（P=0.004）和SUVmax（P=0.022）是PD-L1阳性组DFS/PFS的独立预后指标，而TLG（P=0.012）和CEA（P=0.045）是OS的独立预后指标。在PD-L1阴性组中，肿瘤分期（P=0.002）和CEA（P=0.006）分别是DFS/PFS和OS的唯一独立预后指标。结论18F-FDG PET/CT可预测肺腺癌PD-L1表达，对PD-L1/PD-1免疫治疗的预后有一定的预测价值。
Purpose This study aimed to evaluate the role of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) in expression of tumor programmed death ligand-1 (PD-L1) expression and prognostic significance of 18F-FDG PET/CT at different PD-L1 status in patients with lung adenocarcinoma. Patients and Methods Seventy-three patients with primary lung adenocarcinoma who received 18F-FDG PET/CT before treatment were retrospectively included in this study. Expression of tumor PD-L1, programmed death-1 (PD-1) and glucose metabolic parameters were evaluated. Results Tumor PD-L1 expression was positively correlated with maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), hexokinase II (HK-II) and glucose transporter 1 (GLUT-1) (P<0.0001 for all). SUVmax was a unique independent predictor of tumor PD-L1 expression, with an optimal cut-off value of 9.5. For all the patients, tumor stage (P<0.001) and SUVmax (P=0.009) were independent prognostic indicators of disease-free survival (DFS)/progression-free survival (PFS) while carcino-embryonic antigen (CEA) (P=0.003), Ki67 (P=0.042), PD-L1 (P=0.048) and TLG (P=0.004) were independent prognostic indicators of overall survival (OS). Tumor stage (P=0.004) and SUVmax (P=0.022) were independent prognostic indicators of DFS/PFS while TLG (P=0.012) and CEA (P=0.045) were independent prognostic indicators of OS in the PD-L1-positive group. In the PD-L1-negative group, tumor stage (P=0.002) and CEA (P=0.006) were unique independent prognostic indicators of DFS/PFS and OS, respectively. Conclusion 18F-FDG PET/CT may potentially predict tumor PD-L1 expression and play a role in predicting prognosis of PD-L1/PD-1 immunotherapy in lung adenocarcinoma.