^(18)F- FDG PET/CT显像对肺腺癌PD- L1表达水平的预测价值的研究  

The Predictive Value of ^(18)F-FDG PET/CT in Lung Adenocarcinomafor the PD-L1 Expression Level

作　　者：周丽娟 任德标[1,2] ZHOU Lijuan;REN Debiao(The 909th Hospital of Joint Logistic Support Force,Zhangzhou 363000,China;Dongnan Hospital of Xiamen University,Zhangzhou 363000,China)

机构地区：[1]联勤保障部队第九〇九医院,福建漳州363000 [2]厦门大学附属东南医院,福建漳州363000

出　　处：《标记免疫分析与临床》2023年第6期948-952,996,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的通过氟代脱氧葡萄糖正电子发射计算机断层显像(^(18)F-fluorodeoxyglucose positron emission computed tomography,^(18)F-FDG PET/CT)获得最大标准摄取值(maximum standard uptake value,SUV max),其与肝、纵隔血池的比值得到标准摄取比率(standard uptake value ratio,SUR),分别为SUR-L(SUV max与肝血池的比值)、SUR-BP(SUV max与纵隔血池的比值),研究两者预测肺腺癌(adenocarcinoma,ADC)程序性死亡配体1(programmed cell death-ligand 1,PD-L1)高表达的可行性。方法回顾性分析104例ADC患者影像资料,Pearson卡方检验分析组间差异。Logistic回归模型进行多因素分析,ROC曲线分析最佳临界值。结果性别、Ki-67、空洞、胸膜侵犯、SUR-L、SUR-BP与PD-L1表达相关(P<0.05);多因素分析显示性别、空洞、胸膜侵犯、SUR-L、SUR-BP均是PD-L1高表达的独立预测因素(P<0.05)。SUR-L预测PD-L1高表达的最佳临界值为3.67(灵敏度93.8%,特异性51.1%)。SUR-BP预测PD-L1高表达的最佳临界值为6.35,(灵敏度93.8%,特异性58.0%)。结论SUR-L、SUR-BP在预测ADC患者PD-L1高表达方面发挥重要作用,为免疫治疗提供参考。Objective We obtained maximum standardized uptake values(SUV max)by ^(18)F-Fluorodeoxyglucose positron emission computed tomography(^(18)F-FDG PET/CT).The ratios of SUV max to liver and mediastinal blood pools were obtained as standard uptake value ratio(SUR)for SUR-L and SUR-BP,respectively.We aimed to investigate the correlation between high expression of programmed death ligand 1 and metabolic parameters in lung adenocarcinoma.Methods 104 patients with newly diagnosed adenocarcinoma(ADC)were retrospectively enrolled into the present study.We used Pearson Chi-square tests to analyze differences between groups,logistic regression models for multifactorial analysis,and ROC curves to identify optimal prediction values.Results Gender,Ki-67,cavity,pleural invasion,SUR-L,and SUR-BP were associated with PD-L1 expression(P<0.05).Multivariate analysis showed that gender,cavity,pleural invasion,SUR-L,and SUR-BP were independent predictors of high PD-L1 expression(P<0.05).The optimal threshold value for SUR-L to predict high PD-L1 expression was 3.67(sensitivity 93.8%,specificity 51.1%).The optimal threshold value for SUR-BP to predict high PD-L1 expression was 6.35,(sensitivity 93.8%,specificity 58.0%).Conclusion SUR-L and SUR-BP show utility in predicting PD-L1 high expression.PET/CT can offer useful reference to screen patients for first-line immunotherapy.

关 键 词：氟代脱氧葡萄糖正电子发射计算机断层显像 程序性死亡-配体1 肺腺癌 

分 类 号：R734.2[医药卫生—肿瘤]