Ishimura Mariko, Norikane Takashi, Mitamura Katsuya, Yamamoto Yuka, Arai-Okuda Hanae, Murota Makiko, Ibuki Emi, Kanaji Nobuhiro, Nishiyama Yoshihiro
Department of Radiology, Faculty of Medicine, Kagawa University.
Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University.
Nucl Med Commun. 2022 Mar 1;43(3):304-309. doi: 10.1097/MNM.0000000000001517.
We investigated the relationship between 2-deoxy-2-[18F]fluoro-D-glucose (FDG) PET using volume-based parameters and epidermal growth factor receptor (EGFR) mutation status, programmed death-ligand-1 (PD-L1) expression level, and their combination, in pretreated non-small cell lung cancer (NSCLC).
FDG PET findings and EGFR mutation status and PD-L1 expression level were investigated retrospectively in 93 patients with newly diagnosed NSCLC (77 adenocarcinomas, 16 squamous cell carcinomas). Tumors were divided into six groups: EGFR mutant/negative PD-L1, EGFR mutant/low PD-L1, EGFR mutant/high PD-L1, EGFR wild/negative PD-L1, EGFR wild/low PD-L1, and EGFR wild/high PD-L1. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumor were measured from PET images. The EGFR mutation status and PD-L1 expression level were estimated in tumor tissue specimens and compared with the PET parameters.
None of the PET parameters differed significantly between EGFR-mutated and wild-type EGFR. According to the PD-L1 level, significant differences were detected in SUVmax (P = 0.001) and TLG (P = 0.016), but not MTV. Comparing all six groups, significant difference was detected in only SUVmax (P = 0.011).
Based on the preliminary results of this study, FDG PET may help in the prediction of PD-L1 expression level, but not EGFR mutation status, in patients with newly diagnosed NSCLC. The SUVmax rather than MTV or TLG, may be of value in predicting the six groups according to the combination of EGFR mutation status and PD-L1 expression level.
我们研究了在经预处理的非小细胞肺癌（NSCLC）中，基于体积参数的2-脱氧-2-[¹⁸F]氟-D-葡萄糖（FDG）PET与表皮生长因子受体（EGFR）突变状态、程序性死亡配体1（PD-L1）表达水平及其联合情况之间的关系。
回顾性研究93例新诊断的NSCLC患者（77例腺癌，16例鳞状细胞癌）的FDG PET检查结果、EGFR突变状态和PD-L1表达水平。肿瘤分为六组：EGFR突变/阴性PD-L1、EGFR突变/低PD-L1、EGFR突变/高PD-L1、EGFR野生型/阴性PD-L1、EGFR野生型/低PD-L1和EGFR野生型/高PD-L1。从PET图像测量原发性肿瘤的最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。在肿瘤组织标本中评估EGFR突变状态和PD-L1表达水平，并与PET参数进行比较。
EGFR突变型和野生型EGFR之间的PET参数均无显著差异。根据PD-L1水平，在SUVmax（P = 0.001）和TLG（P = 0.016）中检测到显著差异，但在MTV中未检测到。比较所有六组，仅在SUVmax中检测到显著差异（P = 0.011）。
基于本研究的初步结果，FDG PET可能有助于预测新诊断NSCLC患者的PD-L1表达水平，但不能预测EGFR突变状态。根据EGFR突变状态和PD-L1表达水平的联合情况预测六组时，SUVmax而非MTV或TLG可能具有价值。
