18F-FDG PET/CT代谢参数与非小细胞肺癌PD-L1表达相关性研究

  目的  分析18F-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18F-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。Pearson χ2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SUV_max、TLG均高于阴性组（P<0.05）。PD-L1高表达组SUV_max、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SUV_max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，SUV_max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，SUV_max均是PD-L1阳性、高表达的独立预测因素（P<0.05）。  结论   SUV_max能够预测腺癌患者PD-L1的表达状态，为免疫治疗提供依据。 

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

  Objective  To investigate the relationship between metabolic parameters of 18F-fluorodeoxyglucose positron emission computed tomography (18F-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 18F-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 SUV_max and TLG of the PD-L1 positive group were higher than those of the negative group (P<0.05). SUV_max, 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 SUV_max 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-L1 expression (P>0.05). Multivariate analysis revealed that SUV_max was an independent predictor of PD-L1 expression in NSCLC and ADC (P<0.05), as well as in ALK-negative ADC.   Conclusions  The SUV_max of 18F-FDG PET/CT was a predictor of PD-L1 expression in ADC. It had important clinical value in immunotherapy.