肺癌の免疫治療における腫瘍免疫機能とPET/MRIを用いた画像情報の統合解析

[方法]观察ICI治疗前后外周血嗜中性粒细胞-淋巴细胞比值、各血细胞成分、脾脏等次级淋巴组织和骨髓等造血组织中FLT的蓄积情况，探讨其与ICI疗效的关系。[结果]中位年龄70.4岁，男性23例（92%）。组织学类型分别为腺癌9例（36%）、鳞状细胞癌11例（44%）和其他4例（16%）。分别有1名（4%）、7名（28%）、8名（32%）和9名（36%）患者确认缓解为CR、PR、SD和PD。基线与PD-1抑制剂治疗后2周和6周之间SUV的中位变化（Δ SUVmean 0 -2和Δ SUVmean 0 -6）分别为5.44%和-4.72%。非PD组和PD组的这些值无显著差异（Δ SUV平均值0 -2 7.57 vs.-3.61，P = 0.60; Δ SUV平均值0 -6 -5.28 vs. 3.44，P = 0.69）。任何18F-FLT PET参数的变化（Δ SUV最大值0 -2、Δ SUV平均值0 -2、ΔPPV/BSA 0 -2和ΔTVP/BSA 0 -2）（Th 4、8和12）在基线和两周后之间在非PD组和PD组之间没有显著差异，尽管在治疗开始后两周，18F-FLT蓄积在非PD组中倾向于降低，而在PD组中增加。除Th 4中的Δ SUV平均值0 -6外，非PD组中基线和治疗开始后6周之间胸椎中18 F-FLT蓄积变化的所有参数均显著低于PD组。

【Methods】We evaluated the peripheral blood neutrophil-lymphocyte ratio and each blood cell component, and FLT accumulation in secondary lymphoid tissues such as spleen and hematopoietic tissues such as bone marrow, before and after ICI treatment , to determine their relationship to the therapeutic effect of ICI.【Results】The median age was 70.4 years, 23 (92%) were male. The histologic types were adenocarcinoma, squamous cell carcinoma, and others in nine (36%), 11 (44%), and four (16%) patients, respectively. Confirmed responses were CR, PR, SD, and PD in one (4%), seven (28%), eight (32%), and nine (36%) patients, respectively.The median changes of SUVs between baseline and two and six weeks after PD-1 inhibitor treatment for the spleen (ΔSUVmean0-2 and ΔSUVmean0-6) was 5.44% and -4.72%, respectively. These values did not differ significantly between the non-PD and PD groups (ΔSUVmean0-2 7.57 vs. -3.61, P = 0.60; ΔSUVmean0-6 -5.28 vs. 3.44, P = 0.69). The changes in any 18F-FLT PET parameters (ΔSUVmax0-2, ΔSUVmean0-2, ΔPPV/BSA0-2, and ΔTVP/BSA0-2) of any thoracic vertebrae (Th4, 8, and 12) between baseline and two weeks later were not significantly different between the non-PD and PD groups, although the 18F-FLT accumulation tended to decrease in the non-PD group and increase in the PD group two weeks after treatment initiation. All parameters of change of 18F-FLT accumulation in the thoracic vertebrae between baseline and 6 weeks after treatment initiation, except ΔSUVmean0-6 in Th4, were significantly lower in the non-PD group than in the PD group.