Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 200127, Shanghai, China.
Institute of Clinical Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 200127, Shanghai, China.
Br J Cancer. 2023 Aug;129(3):541-550. doi: 10.1038/s41416-023-02297-9. Epub 2023 Jun 13.
BACKGROUND: PD-L1 promotes glycolysis in tumour cells. We observed a correlation between high PD-L1 expression and high F-FDG uptake in patients with pancreatic ductal adenocarcinoma (PDAC) in a previous study. This study aims to determine the usefulness of F-FDG PET/CT for evaluating the PD-L1 status in PDAC and to elucidate its rationality by integrated analyses. METHODS: For bioinformatics analysis, WGCNA, GSEA and TIMER were applied to analyse the pathways and hub genes associated with PD-L1 and glucose uptake. F-FDG uptake assay was used to determine the glucose uptake rate of PDAC cells in vitro. Related genes expression were verified by RT-PCR and western blot. A retrospective analysis was performed on 47 patients with PDAC who had undergone F-FDG PET/CT. Maximum standardised uptake values (SUV) were determined. The usefulness of SUV for evaluating PD-L1 status was determined by receiver operating characteristic (ROC) curve analysis. RESULTS: Bioinformatics analysis showed that several signalling pathways are associated with both PD-L1 expression and tumour glucose uptake, among which JAK-STAT may be an important one. By in vitro experiments, the regulatory role of PD-L1 on glucose uptake was demonstrated, and its dependency on the JAK-STAT pathway was also verified by the rescue study. The SUV of PD-L1-positive patients was significantly higher than PD-L1-negative in tumour cells (TCs) (6.1 ± 2.3 vs. 11.1 ± 4.2; P < 0.001), and in tumour-infiltrating immune cells (TIICs) (6.4 ± 3.2 vs. 8.4 ± 3.5; P < 0.001). In a multivariate analysis, SUV was significantly associated with PD-L1 expression in TCs and TIICs (P < 0.001 and P = 0.018, respectively). Using SUV cut-off values of 8.15 and 7.75, PD-L1 status in TCs and TIICs could be predicted with accuracies of 91.5% and 74.5%, respectively. CONCLUSION: Higher F-FDG uptake by PDAC is associated with elevated PD-L1 expression. JAK-STAT is an important pathway that mediates PD-L1 to promote glucose uptake in PDAC.
背景:PD-L1 促进肿瘤细胞的糖酵解。我们在之前的研究中观察到,胰腺导管腺癌(PDAC)患者中 PD-L1 高表达与 F-FDG 摄取高之间存在相关性。本研究旨在确定 F-FDG PET/CT 用于评估 PDAC 中 PD-L1 状态的有用性,并通过综合分析阐明其合理性。
方法:为了进行生物信息学分析,应用 WGCNA、GSEA 和 TIMER 分析与 PD-L1 和葡萄糖摄取相关的途径和枢纽基因。在体外测定 PDAC 细胞的葡萄糖摄取率。通过 RT-PCR 和 Western blot 验证相关基因的表达。对 47 例接受 F-FDG PET/CT 的 PDAC 患者进行回顾性分析。测定最大标准化摄取值(SUV)。通过受试者工作特征(ROC)曲线分析确定 SUV 评估 PD-L1 状态的有用性。
结果:生物信息学分析表明,几个信号通路与 PD-L1 表达和肿瘤葡萄糖摄取都有关,其中 JAK-STAT 可能是一个重要的通路。通过体外实验,证明了 PD-L1 对葡萄糖摄取的调节作用,并通过挽救研究证实了其对 JAK-STAT 通路的依赖性。PD-L1 阳性患者的肿瘤细胞(TCs)SUV 值明显高于 PD-L1 阴性患者(6.1±2.3 比 11.1±4.2;P<0.001),肿瘤浸润免疫细胞(TIICs)SUV 值也明显高于 PD-L1 阴性患者(6.4±3.2 比 8.4±3.5;P<0.001)。多变量分析显示,SUV 值与 TCs 和 TIICs 中的 PD-L1 表达显著相关(P<0.001 和 P=0.018)。使用 SUV 截断值 8.15 和 7.75,TCs 和 TIICs 中 PD-L1 状态的预测准确率分别为 91.5%和 74.5%。
结论:PDAC 中更高的 F-FDG 摄取与 PD-L1 表达升高有关。JAK-STAT 是一个重要的通路,介导 PD-L1 促进 PDAC 中的葡萄糖摄取。
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