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治疗前后外周血中性粒细胞/淋巴细胞比例及各血细胞成分、外周血中Flt在脾等次级淋巴组织和骨髓等造血组织中的积聚情况，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%)，鳞癌11例(44%)，其他4例(16%)。1例(4%)、7例(28%)、8例(32%)和9例(36%)患者分别得到CR、PR、SD和PD的确认应答。脾PD-1抑制剂治疗2周和6周后，SUV的中位数变化分别为5.44%和-4.72%。非帕金森病组与帕金森病组之间无显著差异(ΔSUV均值0-2 7.57vs.-3.61，P=0.6；ΔSUV均值0-6-5.28vs.3.44，P=0.69)。治疗开始两周后，非PD组和PD组之间任意胸椎(TH4、8和12)的18F-Flt PET参数(ΔSUVmax 0-2、ΔSUVean 0-2、ΔPPV/BSA0-2和ΔTVP/BSA0-2)的变化没有显著差异，尽管非PD组的18F-Flt积聚在治疗开始后2周有减少的趋势，而PD组的18F-Flt积聚有增加的趋势。非PD组治疗前至治疗后6周胸椎18F-Flt蓄积变化参数除ΔSUV均值为0~6外，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.