Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China.
Second Clinical School, Lanzhou University, Lanzhou, China.
Abdom Radiol (NY). 2024 Apr;49(4):1320-1329. doi: 10.1007/s00261-024-04200-3. Epub 2024 Mar 4.
We aimed to explore the correlation between routine computed tomography (CT) imaging features and programmed cell death ligand-1(PD-L1) expression status in gastric cancer and evaluate the predictive value of imaging parameters for this immunotherapy biomarker.
Patients with gastric adenocarcinoma who underwent abdominal CT three-stage enhanced scan and PD-L1 immunohistochemical testing before treatment were retrospectively examined. All diagnoses were confirmed through pathology. According to the expression status of PD-L1, they were divided into the positive (CPS ≥ 5) or negative group (CPS < 5). Baseline CT imaging features were collected. Diagnostic performances of the different variables were evaluated using receiver operating characteristic (ROC) curve.
In total, 67 patients (17 women and 50 men; mean age: 59.55 ± 10.22 years) with gastric adenocarcinoma were included in the study. The overall stages, probability of maximum lymph node short diameter > 1 cm and peak of lesion enhancement occurring in the arterial phase were statistically significant between the two groups (p < 0.05). Moreover, the arterial enhancement fraction (AEF) was significantly higher in the positive group than that in the negative group (p < 0.05), and ROC curve analysis showed that the AEF exhibited a high evaluation efficacy (area under the curve [AUC] = 0.724 [95% confidence interval (CI): 0.602-0.826]). The combined parameters had the best diagnostic efficacy (AUC = 0.825 [95%CI: 0.716-0.933]), sensitivity (75.00%), and specificity (81.40%).
These findings confirm a correlation between CT imaging features and PD-L1 expression status in gastric cancer, and AEF may help evaluate high PD-L1 expression and select patients suitable for immunotherapy.
本研究旨在探讨胃癌常规计算机断层扫描（CT）影像学特征与程序性死亡配体-1（PD-L1）表达状态之间的相关性，并评估影像学参数对这种免疫治疗生物标志物的预测价值。
回顾性分析了 67 例经腹部 CT 三期增强扫描及 PD-L1 免疫组化检测的胃腺癌患者，所有诊断均经病理证实。根据 PD-L1 的表达状态，将其分为阳性（CPS≥5）或阴性组（CPS<5）。收集基线 CT 影像学特征。采用受试者工作特征（ROC）曲线评估不同变量的诊断性能。
共纳入 67 例胃腺癌患者（17 例女性，50 例男性；平均年龄：59.55±10.22 岁）。两组间总体分期、最大淋巴结短径>1cm 的概率和病变动脉期强化峰值差异均有统计学意义（p<0.05）。此外，阳性组的动脉增强分数（AEF）显著高于阴性组（p<0.05），ROC 曲线分析显示 AEF 具有较高的评价效能（曲线下面积[AUC]为 0.724[95%可信区间（CI）：0.602-0.826]）。联合参数具有最佳的诊断效能（AUC=0.825[95%CI：0.716-0.933]），其灵敏度为 75.00%，特异性为 81.40%。
这些发现证实了 CT 影像学特征与胃癌 PD-L1 表达状态之间存在相关性，AEF 可能有助于评估高 PD-L1 表达并选择适合免疫治疗的患者。
