Oh Ju Hyun, Lee Su Jin, Park Yong-Jin
Department of Pulmonology and Critical Care Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
Department of Pulmonology and Critical Care Medicine, Ajou University Medical Center, Ajou University School of Medicine, Suwon, Republic of Korea.
BMC Cancer. 2025 Feb 28;25(1):379. doi: 10.1186/s12885-025-13727-7.
Airway inflammation is believed to play a crucial role in the development and progression of non-small cell lung cancer (NSCLC). However, no study has yet employed quantified imaging biomarkers to assess airway inflammation in patients with NSCLC. This study aimed to validate the hypothesis that airway inflammation is more pronounced in a large cohort of patients with NSCLC compared to controls, using airway imaging biomarkers derived from fluorine-18-fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET), as well as to explore their associations with clinical parameters.
We retrospectively enrolled 618 patients with NSCLC and 441 controls who underwent F-18 FDG PET/computed tomography (CT). The F-18 FDG PET/CT images were subjected to airway segmentation to determine the airway maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG). We compared the airway PET parameters between patients with NSCLC and controls. Additionally, we investigated the associations between airway PET parameters and tumor SUVmax, stages, smoking pack-years, histological subtypes, systemic inflammation, and lung function in patients with NSCLC.
The median airway SUVmax (P < 0.0001) and TLG (P < 0.0001) were significantly higher in patients with NSCLC than in controls. The median airway SUVmax (P = 0.0098) and TLG (P < 0.0001) were significantly higher in patients with squamous cell carcinoma than in those with adenocarcinoma. Airway SUVmax and TLG showed weak positive correlations with tumor SUVmax, stages, white blood cell count, and neutrophil-to-lymphocyte ratio, but weak to moderate negative correlations with lung function parameters. Airway TLG showed a moderate positive correlation with smoking pack-years.
F-18 FDG PET-derived airway imaging biomarkers were higher in patients with NSCLC than in controls. Additionally, these biomarkers were associated with tumor SUVmax, stages, histological subtypes, serologic inflammatory markers, lung function, and smoking, suggesting their potential to provide insights into the development and severity of NSCLC.
气道炎症被认为在非小细胞肺癌（NSCLC）的发生和发展中起关键作用。然而，尚无研究采用定量成像生物标志物来评估NSCLC患者的气道炎症。本研究旨在验证以下假设：与对照组相比，一大群NSCLC患者的气道炎症更为明显，采用源自氟 - 18 - 氟脱氧葡萄糖（F - 18 FDG）正电子发射断层扫描（PET）的气道成像生物标志物，并探索它们与临床参数的关联。
我们回顾性纳入了618例接受F - 18 FDG PET/计算机断层扫描（CT）的NSCLC患者和441例对照。对F - 18 FDG PET/CT图像进行气道分割，以确定气道最大标准化摄取值（SUVmax）和总病变糖酵解（TLG）。我们比较了NSCLC患者与对照之间的气道PET参数。此外，我们研究了NSCLC患者气道PET参数与肿瘤SUVmax、分期、吸烟包年数、组织学亚型、全身炎症和肺功能之间的关联。
NSCLC患者的气道SUVmax中位数（P < 0.0001）和TLG中位数（P < 0.0001）显著高于对照组。鳞状细胞癌患者的气道SUVmax中位数（P = 0.0098）和TLG中位数（P < 0.0001）显著高于腺癌患者。气道SUVmax和TLG与肿瘤SUVmax、分期、白细胞计数和中性粒细胞与淋巴细胞比值呈弱正相关，但与肺功能参数呈弱至中度负相关。气道TLG与吸烟包年数呈中度正相关。
源自F - 18 FDG PET的气道成像生物标志物在NSCLC患者中高于对照组。此外，这些生物标志物与肿瘤SUVmax、分期、组织学亚型、血清学炎症标志物、肺功能和吸烟有关，表明它们有可能为NSCLC的发生和严重程度提供见解。
