Department of Nuclear Medicine of Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
Ann Nucl Med. 2020 May;34(5):322-328. doi: 10.1007/s12149-020-01451-0. Epub 2020 Mar 4.
OBJECTIVES: Programmed cell death-ligand 1 (PD-L1) is expressed on tumor cells (TC) and tumor-infiltrating immune cells (IC). We conducted a retrospective study to investigate the relationship between PD-L1 expression on TC/IC and F-FDG uptake in patients with surgically resected non-small cell lung cancer (NSCLC). METHODS: Total 362 NSCLC patients (297 adenocarcinoma and 65 squamous cell carcinoma) who underwent preoperative F-FDG-PET/CT imaging were analyzed retrospectively. Immunohistochemistry analysis was performed for PD-L1 expression on TC and IC in NSCLC specimens with 28-8 antibody. The cut-off value of 5% for defining PD-L1 positivity was determined according to previous trials. The association between PD-L1 expression and clinicopathological variables were analyzed, including age, gender, smoking status, tumor diameter, lymph node metastasis, stage and the maximum standardized uptake value (SUVmax). RESULTS: PD-L1 positive expression was 50.8% (184/362) in NSCLC patients. Its positive expression on TC and IC were 24.3% (88/362) and 42.5% (154/362), respectively. SUVmax was significantly higher in patients with PD-L1 positive expression on TC or IC than that with negative. Multivariate analysis demonstrated that PD-L1 expression were correlated with SUVmax. The best cut-off value of SUVmax for PD-L1 expression on TC/IC was 8.5 [area under the curve (AUC) = 0.607, 95% CI 0.549-0.665, P = 0.001, sensitivity 50.5% and specificity 71.4%] determined by ROC curve. CONCLUSION: High SUVmax is linked to PD-L1 expression on TC and IC in our patients with surgically resected non-small cell lung cancer. F-FDG-PET/CT imaging may be used to predict the PD-L1 expression on TC and IC in NSCLC patients.
目的:程序性死亡配体 1(PD-L1)在肿瘤细胞(TC)和肿瘤浸润免疫细胞(IC)上表达。我们进行了一项回顾性研究,以调查手术切除的非小细胞肺癌(NSCLC)患者 TC/IC 上的 PD-L1 表达与 F-FDG 摄取之间的关系。
方法:共分析了 362 例接受术前 F-FDG-PET/CT 成像的 NSCLC 患者(297 例腺癌和 65 例鳞状细胞癌)的回顾性数据。使用 28-8 抗体对 NSCLC 标本中 TC 和 IC 上的 PD-L1 表达进行免疫组织化学分析。根据先前的试验,确定了 5%作为 PD-L1 阳性的截断值。分析了 PD-L1 表达与临床病理变量之间的关系,包括年龄、性别、吸烟状态、肿瘤直径、淋巴结转移、分期和最大标准化摄取值(SUVmax)。
结果:在 NSCLC 患者中,PD-L1 阳性表达率为 50.8%(184/362)。TC 和 IC 上的 PD-L1 阳性表达率分别为 24.3%(88/362)和 42.5%(154/362)。TC/IC 上 PD-L1 阳性表达患者的 SUVmax 显著高于阴性表达患者。多变量分析表明,PD-L1 表达与 SUVmax 相关。通过 ROC 曲线确定的 TC/IC 上 PD-L1 表达的最佳 SUVmax 截断值为 8.5[曲线下面积(AUC)=0.607,95%CI 0.549-0.665,P=0.001,敏感性 50.5%,特异性 71.4%]。
结论:在我们手术切除的非小细胞肺癌患者中,高 SUVmax 与 TC 和 IC 上的 PD-L1 表达相关。F-FDG-PET/CT 成像可用于预测 NSCLC 患者 TC 和 IC 上的 PD-L1 表达。
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