Published in:
01-05-2020 | NSCLC | Original Article
18F-FDG maximum standard uptake value predicts PD-L1 expression on tumor cells or tumor-infiltrating immune cells in non-small cell lung cancer
Published in: Annals of Nuclear Medicine | Issue 5/2020
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Objectives
Programmed cell death-ligand 1 (PD-L1) is expressed on tumor cells (TC) and tumor-infiltrating immune cells (IC). We conducted a retrospective study to investigate the relationship between PD-L1 expression on TC/IC and 18F-FDG uptake in patients with surgically resected non-small cell lung cancer (NSCLC).
Methods
Total 362 NSCLC patients (297 adenocarcinoma and 65 squamous cell carcinoma) who underwent preoperative 18F-FDG-PET/CT imaging were analyzed retrospectively. Immunohistochemistry analysis was performed for PD-L1 expression on TC and IC in NSCLC specimens with 28–8 antibody. The cut-off value of 5% for defining PD-L1 positivity was determined according to previous trials. The association between PD-L1 expression and clinicopathological variables were analyzed, including age, gender, smoking status, tumor diameter, lymph node metastasis, stage and the maximum standardized uptake value (SUVmax).
Results
PD-L1 positive expression was 50.8% (184/362) in NSCLC patients. Its positive expression on TC and IC were 24.3% (88/362) and 42.5% (154/362), respectively. SUVmax was significantly higher in patients with PD-L1 positive expression on TC or IC than that with negative. Multivariate analysis demonstrated that PD-L1 expression were correlated with SUVmax. The best cut-off value of SUVmax for PD-L1 expression on TC/IC was 8.5 [area under the curve (AUC) = 0.607, 95% CI 0.549–0.665, P = 0.001, sensitivity 50.5% and specificity 71.4%] determined by ROC curve.
Conclusion
High SUVmax is linked to PD-L1 expression on TC and IC in our patients with surgically resected non-small cell lung cancer. 18F-FDG-PET/CT imaging may be used to predict the PD-L1 expression on TC and IC in NSCLC patients.