18F-FDG PET/CT代谢参数与非小细胞肺癌PD-L1表达相关性研究  

The correlation between PD-L1 expression and metabolic parameters of ^(18)F-FDG PET/CT in non-small cell lung cancer

作　　者：徐鑫 李继会 戴娜[1] 章斌[1] 桑士标[1] 邓胜明[1,2] Xin Xu;Jihui Li;Na Dai;Bin Zhang;Shibiao Sang;Shengming Deng(Department of Nuclear Medicine,The First Affiliated Hospital of Soochow University,Suzhou 215006,China;State Key Laboratory of Radiation Medicine and Protection,Soochow University,Suzhou 215123,China)

机构地区：[1]苏州大学附属第一医院核医学科,苏州市215006 [2]放射医学与辐射防护国家重点实验室

出　　处：《中国肿瘤临床》2022年第7期338-344,共7页Chinese Journal of Clinical Oncology

基　　金：江苏省青年医学重点人才项目(编号:QNRC2016749);姑苏卫生青年拔尖人才项目(编号:GSWS2020013);苏州市民生科技计划项目(编号:SYS2019038);放射医学与辐射防护国家重点实验室项目(编号:GZK1202127)资助。

摘　　要：目的:分析^(18)F-FDG PET/CT代谢参数与非小细胞肺癌(non-small cell lung cancer,NSCLC)患者PD-L1表达的关系。方法:回顾性分析2019年3月至2021年7月于苏州大学附属第一医院行^(18)F-FDG PET/CT显像的241例NSCLC患者临床资料,依据PD-L1表达状态分为阳性和阴性组、高表达和低表达组。Pearsonχ^(2)检验比较组间分类变量的差异;t检验和Mann-Whitney U检验比较组间连续变量的差异。Logistic回归模型进行单因素和多因素分析。结果:在NSCLC中,PD-L1阳性组SUVmax、TLG均高于阴性组(P<0.05)。PD-L1高表达组SUVmax、MTV、TLG均高于低表达组(P<0.05)。鳞癌PD-L1阳性率、高表达率均高于腺癌(P<0.05)。在腺癌中,PD-L1阳性组、高表达组的SUVmax分别高于阴性组、低表达组(P<0.05),组间MTV、TLG差异无统计学意义(P>0.05)。在鳞癌中,代谢参数与PD-L1表达无明显相关性(P>0.05)。多因素分析表明,在NSCLC的腺癌中,SUVmax是PD-L1阳性的独立预测因素(P<0.05),也是PD-L1高表达的独立预测因素(P<0.05)。在ALK阴性腺癌中,SUVmax均是PD-L1阳性、高表达的独立预测因素(P<0.05)。结论:SUVmax能够预测腺癌患者PD-L1的表达状态,为免疫治疗提供依据。Objective: To investigate the relationship between metabolic parameters of;F-fluorodeoxyglucose positron emission computed tomography(^(18)F-FDG PET/CT) and the expression of programmed death-ligand 1(PD-L1) in patients with non-small cell lung cancer(NSCLC).Methods: A total of 241 NSCLC patients who received preoperative^(18)F-FDG PET/CT were retrospectively enrolled in the present study at The First Affiliated Hospital of Soochow University from March 2019 to July 2021. In terms of the expression of PD-L1, patients were assigned into positive and negative groups, and high expression and low expression groups. A Chi-square test was used to analyze the difference between the two categorical variables, while a Mann–Whitney U test or t-test was used for the continuous variables. Multivariate analyses between the expression of PD-L1 and characteristics were analyzed by Logistic regression analysis. Results: In NSCLC, the SUVmax and TLG of the PD-L1 positive group were higher than those of the negative group(P<0.05). SUVmax, MTV, and TLG in the PD-L1 high expression group were higher than those in the low expression group(P<0.05). PD-L1 positive and high expression rates were higher in squamous carcinoma(SCC) than in adenocarcinoma(ADC). In ADC, the SUVmax of PD-L1 positive and high expression groups were higher than those of the negative and low expression groups, respectively(P<0.05). In SCC, there was no significant correlation between metabolic parameters and PD-L1expression(P>0.05). Multivariate analysis revealed that SUVmax was an independent predictor of PD-L1 expression in NSCLC and ADC(P<0.05), as well as in ALK-negative ADC. C onclusions: The SUVmax of ^(18)F-FDG PET/CT was a predictor of PD-L1 expression in ADC. It had important clinical value in immunotherapy.

关 键 词：非小细胞肺癌 程序性死亡-配体1 氟代脱氧葡萄糖 正电子发射计算机断层显像 

分 类 号：R734.2[医药卫生—肿瘤]