Prognostic significance of volume-based 18F-FDG PET/CT parameters and correlation with PD-L1 expression in patients with surgically resected lung adenocarcinoma. Issue 35 (3rd September 2021)

• Record Type: Journal Article
• Authors: Wang, Dalong; Li, Yingci; Chen, Xiaolin; Li, Ping
• Editors: Chalishazar., Milind
• Is Part Of: Medicine. Volume 100:Issue 35(2021)
• Page Start: e27100
• Publication Date: 2021-09-03
• Subjects: FDG -- lung adenocarcinoma -- PET/CT -- prognosis -- programmed cell death-ligand 1; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000027100
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: The aim of this study was to retrospectively analyze 18 F-FDG positron emission tomography/computed tomography ( 18 F-FDG PET/CT) metabolic variables, programmed death-ligand 1 (PD-L1) and phosphorylated signal transducer and activator of transcription 3 (p-STAT3) tumor expression, and other factors as predictors of disease-free survival (DFS) in patients with lung adenocarcinoma (LUAD) (stage IA–IIIA) who underwent surgical resection. We still lack predictor of immune checkpoint (programmed cell death-1 [PD-1]/PD-L1) inhibitors. Herein, we investigated the correlation between metabolic parameters from 18 F-FDG PET/CT and PD-L1 expression in patients with surgically resected LUAD. Seventy-four patients who underwent 18 F-FDG PET/CT prior to treatment were consecutively enrolled. The main 18 F-FDG PET/CT-derived variables were primary tumor maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Surgical tumor specimens were analyzed for PD-L1 and p-STAT3 expression using immunohistochemistry. Correlations between immunohistochemistry results and 18 F-FDG PET/CT-derived variables were compared. Associations of PD-L1 and p-STAT3 tumor expression, 18 F-FDG PET/CT-derived variables, and other factors with DFS in resected LUAD were evaluated. All tumors were FDG-avid. The cutoff values of low and high SUVmax, MTV, and TLG were 12.60, 14.87, and 90.85, respectively. The results indicated that TNM stage, PD-L1 positivity, and high 18 F-FDG PET/CT metabolic volume parameters (TLG ≥90.85 or MTV ≥14.87) were independent predictors of worse DFS in resected LUAD. No 18 F-FDG metabolic parameters associated with PD-L1 expression were observed (chi-square test), but we found that patients with positive PD-L1 expression have significantly higher SUVmax ( P = .01), MTV ( P = .00), and TLG ( P = .00) than patients with negative PD-L1 expression. 18 F-FDG PET/CT metabolic volume parameters (TLG ≥90.85 or MTV ≥14.87) were more helpful in prognostication than the conventional parameter (SUVmax), PD-L1 expression was an independent predictor of DFS in patients with resected LUAD. Metabolic parameters on 18 F-FDG PET/CT have a potential role for 18 F-FDG PET/CT in selecting candidate LUAD for treatment with checkpoint inhibitors.