Tien Cong Bui, Cam Phuong Pham, Thai Pham-Van, Thuong Vu-Le, Quang Hung Nguyen, Hang Dong-Thi, Anh Tuan Hoang, Minh Khuy Doan, Tuyen Pham-Van, Minh Duc Nguyen
Department of Nuclear Medicine, Ha Noi Medical University, Hanoi, Vietnam.
Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam.
Front Med (Lausanne). 2022 May 13;9:895401. doi: 10.3389/fmed.2022.895401. eCollection 2022.
This study evaluated the prognostic ability of F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET)/computed tomography (CT) in patients with stage IV adenocarcinoma lung cancer to detect protein death-ligand 1 (PD-L1) expression levels.
In total, 86 patients with stage IV adenocarcinoma lung cancer underwent F-FDG PET/CT imaging and PD-L1 expression evaluation before treatment from February 2019 to November 2020 at Bach Mai Hospital, Hanoi, Vietnam. The assessed patient characteristics in this study included sex, age, smoking status, epidermal growth factor receptor () mutation, PD-L1 expression level, survival status, tumor, node, and metastasis (TNM) stage, and metastasis locations.
The average age was 62.23 ± 9.51 years, and men and women represented 67.4% and 32.6% of the population, respectively. The mutation rate was 36%. PD-L1 expression was negative (detected in <1% of the tumor) in 40.7% of cases and positive in 59.3% of cases (detected in 1-49% of the tumor in 32.6%; detected in ≥50% of the tumor in 26.7%). The mean maximum standardized uptake value (SUV) was 11.09 ± 3.94. SUV was significantly higher in PD-L1-positive tumors than in PD-L1-negative tumors (12.24 ± 4.01 and 9.43 ± 3.22, respectively; = 0.001). Receiver operating characteristic curve analysis revealed an area under the curve of SUVmax was 0.681 (95% confidence interval 0.570-0.793, = 0.004). Compared with PD-L1-negative cases, SUV was significantly different in all PD-L1-positive cases ( = 0.001), weakly PD-L1-positive cases (1-49%, = 0.005), and strongly PD-L1-positive cases (≥50%, = 0.003). PD-L1 expression levels were significantly associated with SUV ( = 0.001), tumor size ( = 0.022), and mutation status ( = 0.045).
SUV in the primary lesions was able to predict PD-L1 expression and may play a role in predicting PD-L1 immunotherapy efficacy in patients with stage IV lung adenocarcinoma.
本研究评估了氟脱氧葡萄糖（F-FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）在IV期肺腺癌患者中检测程序性死亡配体1（PD-L1）表达水平的预后能力。
2019年2月至2020年11月期间，越南河内巴美医院共有86例IV期肺腺癌患者在治疗前接受了F-FDG PET/CT成像及PD-L1表达评估。本研究评估的患者特征包括性别、年龄、吸烟状况、表皮生长因子受体（EGFR）突变、PD-L1表达水平、生存状况、肿瘤、淋巴结及转移（TNM）分期和转移部位。
平均年龄为62.23±9.51岁，男性和女性分别占总人数的67.4%和32.6%。EGFR突变率为36%。40.7%的病例中PD-L1表达为阴性（在<1%的肿瘤中检测到），59.3%的病例中为阳性（32.6%在1%-49%的肿瘤中检测到；26.7%在≥50%的肿瘤中检测到）。平均最大标准化摄取值（SUV）为11.09±3.94。PD-L1阳性肿瘤的SUV显著高于PD-L1阴性肿瘤（分别为12.24±4.01和9.43±3.22；P = 0.001）。受试者工作特征曲线分析显示，SUVmax曲线下面积为0.681（95%置信区间0.570-0.793，P = 0.004）。与PD-L1阴性病例相比，所有PD-L1阳性病例（P = 0.001）、弱阳性PD-L1病例（1%-49%，P = 0.005）和强阳性PD-L1病例（≥50%，P = 0.003）的SUV均有显著差异。PD-L1表达水平与SUV（P = 0.001）、肿瘤大小（P = 0.022）和EGFR突变状态（P = 0.045）显著相关。
原发灶的SUV能够预测PD-L1表达，可能在预测IV期肺腺癌患者的PD-L1免疫治疗疗效中发挥作用。
