Candiolo Cancer Institute, FPO-IRCCS, Turin, Italy.
Department of Oncology, University of Turin, San Luigi Hospital, Turin, Italy.
Thorac Cancer. 2023 Aug;14(24):2473-2483. doi: 10.1111/1759-7714.15032. Epub 2023 Jul 13.
Inflammation in non-small cell lung cancer (NSCLC) may impair the response to immune checkpoint inhibitors (ICIs) and can be indicated by peripheral blood inflammatory indexes. 2-deoxy-2-[ F]fluoro-D-glucose positron emission tomography/computed tomography ([ F] FDG-PET/CT) may be used as a marker of inflammation by measuring glucose metabolism in different colonic sites.
This retrospective analysis aimed to investigate the correlation between [ F] FDGPET/CT SUV in six gastrointestinal districts, the spleen, the pharynx and the larynx alongside the most avid tumor lesion with peripheral blood inflammatory indexes, including the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammatory index (SII, i.e., NLR times platelets) and lactate dehydrogenase (LDH), in patients with [ F] FDG-PET/CT staged IV NSCLC who received first-line immune checkpoint inhibitors (ICIs). The role of SUV and peripheral blood inflammatory indexes in predicting overall survival (OS) and progression-free survival (PFS) was then explored.
A total of 43 patients were treated with first-line ICI alone (58%) or in combination with chemotherapy (42%). A significant correlation was only found between the rectosigmoid SUV and NLR (p = 0.0465). NLR >5.5 and LDH > 333.5 were associated with a worse OS (p = 0.033 and p = 0.009, respectively). The SII was associated with a worse PFS in patients treated with ICI alone (p = 0.033). None of the SUV were significantly associated with OS or PFS, although a high left colon SUV showed a trend toward a worse PFS.
There was no significant correlation between [ F]FDG PET/CT uptake in different anatomical sites, and in the tumor, and systemic immune-inflammatory indexes. The prognostic role of high left colon SUV deserves further investigation.
非小细胞肺癌（NSCLC）中的炎症可能会影响免疫检查点抑制剂（ICI）的反应，外周血炎症指标可以提示炎症。2-脱氧-2-[F]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描（[F]FDG-PET/CT）可以通过测量不同结直肠部位的葡萄糖代谢来作为炎症的标志物。
本回顾性分析旨在研究 IV 期 NSCLC 患者行[F]FDG-PET/CT 分期后，接受一线免疫检查点抑制剂（ICI）治疗时，六个胃肠道区域、脾脏、咽和喉的[F]FDG-PET/CT SUV 与外周血炎症指标（包括中性粒细胞与淋巴细胞比值（NLR）、全身性免疫炎症指数（SII，即 NLR 乘以血小板）和乳酸脱氢酶（LDH））之间的相关性。然后探讨 SUV 和外周血炎症指标对总生存期（OS）和无进展生存期（PFS）的预测作用。
共有 43 例患者单独接受一线 ICI 治疗（58%）或联合化疗（42%）。仅直肠乙状结肠 SUV 与 NLR 之间存在显著相关性（p=0.0465）。NLR>5.5 和 LDH>333.5 与 OS 较差相关（p=0.033 和 p=0.009）。单独接受 ICI 治疗的患者中，SII 与 PFS 较差相关（p=0.033）。虽然左半结肠 SUV 较高与 PFS 较差有一定趋势，但 SUV 与 OS 或 PFS 之间均无显著相关性。
不同解剖部位和肿瘤摄取[F]FDG-PET/CT 与全身免疫炎症指标之间无显著相关性。左半结肠 SUV 较高的预后作用值得进一步研究。
