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目的 探讨程序性死亡配体1(PD-L1)表达水平与非小细胞肺癌患者的临床病理特征及正电子发射断层扫描/计算机断层成像(PET/CT)代谢参数的相关性。方法 回顾性收集2022年1月—2022年6月术前行PET/CT检查的80例非小细胞肺癌患者临床资料。依据免疫组织化学检测中肿瘤比例评分(TPS)将PD-L1表达水平分为高表达组(TPS≥50%,61例)与低表达组(TPS<50%,19例)。收集患者的基本临床资料(性别、年龄、血糖、吸烟史)及病理特征(病理分型、临床分期、是否淋巴结转移、原发灶数量)，并记录PET/CT代谢参数[最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)、代谢肿瘤体积(MTV)、总糖酵解量(TLG)]。采用单因素与多因素Logistic回归分析PD-L1高表达的独立影响因素，并进一步通过Spearman秩相关系数评估PD-L1表达与各项指标的相关性。结果 PD-L1高表达组与低表达组在病理分型、临床分期、淋巴结转移等指标上的差异无统计学意义(P>0.05)。PD-L1高表达组的SUVmax、SUVmean、MTV和TLG均显著低于低表达组(P<0.05)。多因素Logistic回归分析显示，SUVmax、MTV为PD-L1高表达的独立影响因素(P<0.05)。Spearman秩相关分析显示，PD-L1表达水平分别与SUVmax、SUVmean、MTV及TLG呈负相关(P<0.001)。结论 PET/CT可量化肿瘤代谢活性，为无创评估PD-L1表达状态提供了参考，有助于免疫治疗的个体化分层。
Abstract：Objective To investigate the correlation between programmed death-ligand 1(PD-L1)expression levels,clinicopathological characteristics, and metabolic parameters of18F-fluorodeoxyglucose(FDG) positron emission tomography/computed tomography(PET/CT) in patients with non-small cell lung cancer(NSCLC). Methods Retrospective analysis of clinical data from 80 NSCLC patients, who underwent preoperative18F-FDG PET/CT examinations at our hospital between January 2022 and June 2022 was performed. PD-L1 expression was categorized according to the tumor proportion score(TPS) on immunohistochemical testing into highexpressing group(TPS≥50%, n=61) and low-expressing group(TPS<50%, n=19). The patients' basic clinical information including gender, age, smoking history and blood glucose level as well as pathological characteristics including pathological type, clinical stage,presence of lymph node metastasis, and number of primary lesions was documented. Metabolic parameters on18F-FDG PET/CT including maximum standardized uptake value(SUVmax), mean standardized uptake value(SUVmean), metabolic tumor volume(MTV), and total lesion glycolysis(TLG) were determined. Independent factors influencing PD-L1 expression were analyzed using univariate and multivariate logistic regression analyses. Spearman rank correlation coefficient was determined to assess the correlations between PD-L1 expression and these parameters. Results There were no significant differences between the high and low PD-L1 expression groups in terms of pathological subtype, clinical stage, and lymph node metastasis(P>0.05). On PET/CT, the SUVmax, SUVmean, MTV, and TLG were significantly lower in the high PD-L1 expression group compared to the low expression group(P<0.05). Multivariate logistic regression analysis identified SUVmaxand MTV as independent influencing factors for high PD-L1 expression(P<0.05). Spearman rank correlation analysis showed that the PD-L1 expression level was negatively correlated with SUVmax, SUVmean, MTV, and TLG(r=-0.322,-0.328,-0.589,-0.636; P<0.001). Conclusion18F-FDG PET/CT allows non-invasive quantification of tumor metabolic activity and assessment of PD-L1 expression status in NSCLC. It can aid individualized immunotherapy planning of these patients.
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基本信息:
中图分类号:R734.2;R730.44
引用信息:
[1]章明,楼云龙.PET/CT代谢参数与非小细胞肺癌PD-L1表达相关性的探讨[J].影像诊断与介入放射学,2025,34(06):371-376.