| 非小细胞肺癌原发灶PET/CT SUVmax 与免疫细胞亚群浸润的相关性及其临床意义 |
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| 引用本文： | 吴占波,赵宁,申学杰,潘娜,王扬,金昊,魏枫,任秀宝. 非小细胞肺癌原发灶PET/CT SUVmax 与免疫细胞亚群浸润的相关性及其临床意义[J]. 中国肿瘤临床, 2017, 44(3): 112-117. DOI: 10.3969/j.issn.1000-8179.2017.03.179 |
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| 作者姓名： | 吴占波 赵宁 申学杰 潘娜 王扬 金昊 魏枫 任秀宝 |
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| 作者单位： | 天津医科大学肿瘤医院生物治疗科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室，天津市恶性肿瘤临床医学研究中心，天津市肿瘤免疫与生物治疗重点实验室（天津市300060） |
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| 基金项目： | 本文课题受国家科技支撑计划项目(编号2015BAI12B12)，国家自然科学基金项目(编号81272221、81401887)资助This work was supported by the National Science and Technology Support Plan(2015BAI12B12)，the National Natural Science Foundation of China(.81272221 and 81401887) |
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| 摘 要： | 目的 通过分析18F-脱氧葡萄糖（fluorodeoxyglucose，FDG）在非小细胞肺癌（non-small cell lung cancer，NSCLC）原发灶最大标准摄取值（maximum standardized uptake value，SUVmax）与免疫细胞亚群浸润的相关性，初步探讨其在肺癌治疗及判断预后中的指导价值。 方法 回顾性分析2008年4月至2014年8月在天津医科大学肿瘤医院收治且接受正电子发射断层扫描/计算机体层摄影（positron emission tomography/computed tomography，PET/CT）检查及肺癌根治术的NSCLC患者119例，其中鳞癌32例、腺癌87例，应用免疫组织化学方法检测肿瘤原发灶CD3+肿瘤浸润淋巴细胞（tumor infiltrating lymphocytes，TILs）、CD8+TILs、CD68+肿瘤相关树巨噬细胞（tumor-associated macrophages，TAMs）、CD163+TAMs及CD11c+树突状细胞（dendritic cells，DCs）的浸润水平，采用Pearson法分析各免疫细胞亚群与SUVmax的相关性，同时采用Kaplan-Meier法及多因素Cox回归模型分析患者的生存状况。 结果 肿瘤原发灶SUVmax与CD8+TILs（r=0.332，P＜0.001）和CD163+TAMs（r=0.223，P=0.015）的浸润水平呈正相关，而与CD3+TILs、CD68+TAMs和CD11c+DCs的浸润水平无明显相关性。单因素分析提示TNM分期、SUVmax、肿瘤大小及免疫浸润细胞CD163+TAMs和CD11c+DCs与患者的预后有关，多因素分析仅TNM分期和肿瘤大小为患者的独立预后因素。 结论 肿瘤原发灶PET/CT SUVmax与部分免疫细胞亚群浸润水平显著相关，提示18F-FDG PET/CT可间接反应肿瘤微环境的免疫状态，这对NSCLC患者预后判断以及采取及时有效的干预治疗措施具有重要的指导价值。
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| 关 键 词： | PET/CT 非小细胞肺癌 肿瘤微环境 免疫组织化学 最大标准摄取值 预后 |
| 收稿时间： | 2016-10-10 |
Correlation of PET/CT SUVmax with infiltration level of immune cells in patients with non-small cell lung cancer and its clinical significance |
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| Affiliation: | Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy Tianjin 300060, China |
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| Abstract: | Objective:This study assessed the relationship between 18F-FDG maximum standard uptake value (SUVmax) and infiltration level of immune cells in patients with non-small cell lung cancer (NSCLC) and explored its significance in NSCLC treatment and progno-sis. Methods:From April 2008 to August 2014, 119 patients with NSCLC (32 squamous cell carcinoma cases and 87 adenocarcinoma cases) who underwent primary tumor resection and PET/CT imaging at Tianjin Medical University Cancer Institute and Hospital were collected and retrospectively analyzed. The infiltration levels of CD3+tumor infiltrating lymphocytes (TILs), CD8+TILs, CD68+tumor-as-sociated macrophages (TAMs), CD163+TAMs, and CD11c+dendritic cells (DCs) were determined using immunohistochemistry. More-over, the correlation between infiltration level of immune cells and SUVmax was analyzed via Pearson correlation analysis. Survival out-comes were analyzed using the Kaplan-Meier method and multivariate Cox proportional hazard model. Result:A positive correlation was found between SUVmax and the infiltration level of CD8+TILs (r=0.332;P<0.001) and CD163+TAMs (r=0.223;P=0.015). However, no significant correlation was noted between SUVmax and infiltration levels of CD3+TILs, CD68+TAMs, and CD11c+DCs. Univariate anal-ysis showed that TNM staging, SUVmax, tumor size, and infiltration levels of CD163+TAMs and CD11c+DCs were correlated with pa-tient prognosis. Multivariate analysis demonstrated that TNM stage and tumor size were independent prognostic factors. Conclusion:The present study showed a direct association between SUVmax and the infiltration level of immune cells, thereby suggesting a poten-tial role for 18F-FDG PET/CT to indirectly reflect the immune status of the tumor microenvironment. This study can be used as a crucial reference for the prognosis and selection of NSCLC patient candidates for timely and effective intervention. |
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| Keywords: | PET/CT Non-small cell lung cancer tumor microenvironment immunohistochemistry SUVmax prognosis |
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