肺鳞癌中肿瘤相关免疫与 18F-FDG-PET 的相关性。
Correlation of tumor-related immunity with 18F-FDG-PET in pulmonary squamous-cell carcinoma.
机构信息
Department of Respiratory Medicine, Gunma University, Graduate School of Medicine, Gunma 371-8511, Japan.
Department of Oncology Clinical Development, Gunma University, Graduate School of Medicine, Gunma 371-8511, Japan.
出版信息
Lung Cancer. 2018 May;119:71-77. doi: 10.1016/j.lungcan.2018.03.001. Epub 2018 Mar 16.
OBJECTIVES
2-Deoxy-2-[fluorine-18] fluoro-d-glucose with positron emission tomography (F-FDG-PET) is a clinically useful tool for cancer evaluation. F-FDG accumulation in tumor cells is known to be correlated with the presence of glucose transporter 1 (GLUT1) and hypoxia-inducible factor-1α (HIF-1α). Although anti-programmed death-1 (PD-1) antibody treatments have been approved, no suitable predictor of significant responders has been identified. Based on the existing information, we investigated the relationship between tumor immunity (including PD-L1) and F-FDG uptake in patients with surgically resected pulmonary squamous-cell carcinoma (SQC).
MATERIALS AND METHODS
This study included 167 patients (153 men and 14 women) with SQC who underwent F-FDG PET. Tumor sections were stained by immunohistochemistry for GLUT1, HIF-1α, PD-L1, CD4, CD8, and Foxp3. The relationship between clinicopathological features and F-FDG uptake was analyzed. Student's t-test, the χ test, non-parametric Spearman's rank test and the Kaplan-Meier method were used to show associations between variables.
RESULTS
The rate of positive PD-L1 expression was 79% (132/167), and PD-L1 expression was significantly associated with GLUT1 (P < 0.01), HIF-1α (P < 10), and CD8 (P < 1 × 10) expression. The SUV of F-FDG was significantly correlated with PD-L1 (P = 0.02) and GLUT1 (P < 0.01) expression. Multivariate analysis demonstrated that advanced stage, elevated PD-L1 expression, and elevated SUV were independent prognostic factors for predicting poor OS. Among patients with a high SUV, multivariate analysis confirmed that advanced stage and high PD-L1 expression were independent prognostic factors for poor OS; however, there was no significant difference among patients with a low SUV.
CONCLUSION
High SUV on F-FDG-PET is associated with PD-L1 expression but is an independent prognostic factor for OS in our population of surgically resected pulmonary squamous-cell carcinoma.
目的
正电子发射断层扫描（PET）用 2-脱氧-2-[氟-18]氟代-D-葡萄糖（F-FDG-PET）是评估癌症的一种临床有用的工具。已知肿瘤细胞中 F-FDG 的积累与葡萄糖转运蛋白 1（GLUT1）和缺氧诱导因子-1α（HIF-1α）的存在相关。尽管已经批准了抗程序性死亡-1（PD-1）抗体治疗，但尚未确定合适的显著应答预测因子。基于现有信息，我们研究了手术切除的肺鳞状细胞癌（SQC）患者的肿瘤免疫（包括 PD-L1）与 F-FDG 摄取之间的关系。
材料和方法
本研究纳入了 167 例接受 F-FDG PET 的 SQC 患者（153 名男性和 14 名女性）。通过免疫组织化学对 GLUT1、HIF-1α、PD-L1、CD4、CD8 和 Foxp3 进行染色。分析了临床病理特征与 F-FDG 摄取之间的关系。采用学生 t 检验、卡方检验、非参数 Spearman 秩检验和 Kaplan-Meier 法显示变量之间的关联。
结果
PD-L1 阳性表达率为 79%（132/167），PD-L1 表达与 GLUT1（P<0.01）、HIF-1α（P<0.01）和 CD8（P<1×10）表达显著相关。F-FDG 的 SUV 与 PD-L1（P=0.02）和 GLUT1（P<0.01）表达显著相关。多因素分析表明，晚期、PD-L1 高表达和 SUV 升高是预测总生存期（OS）不良的独立预后因素。在 SUV 较高的患者中，多因素分析证实晚期和 PD-L1 高表达是 OS 不良的独立预后因素；然而，在 SUV 较低的患者中没有显著差异。
结论
F-FDG-PET 上的高 SUV 与 PD-L1 表达相关，但在我们手术切除的肺鳞状细胞癌患者中，是 OS 的独立预后因素。
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