Abstract:

Objective　To explore the correlation of programmed death-ligand 1 (PD-L1) expression with clinical pathological characteristics and ¹⁸F-FDG PET/CT metabolic parameters in esophageal squamous cell carcinoma. Methods　The clinical pathological characteristics, and preoperative ¹⁸F-FDG PET/CT data of 91 patients with esophageal squamous cell carcinoma who underwent surgery in Jieyang People's Hospital from January 2019 to August 2022 were retrospectively analyzed. Among them, there were 66 males and 25 females, with a median age of 65. The PD-L1 expression was positive in 45 cases and negative in 46 cases. The correlation of PD-L1 expression level with gender, age, tumor location, tumor differentiation degree, neural bundle invasion, vascular cancer embolism, T stage, N stage, TNM stage, maximum standardized uptake value (SUV_max), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary lesion in esophageal squamous cell carcinoma were analyzed. The Mann-Whitney U nonparametric test, χ² test, Spearman correlation analysis, and receiver operating characteristic curve (ROC) were used. Results　Positive PD-L1 expression was positively correlated with T stage, SUV_max, and TLG (r=0.215, 0.297, and 0.264; all P<0.05). The areas under the ROC's of SUV_max and TLG for predicting PD-L1 expression were 0.671 and 0.623, respectively. Conclusions　PD-L1 expression is correlated with T staging and metabolic parameters SUV_max and TLG from ¹⁸F-FDG PET/CT in primary esophageal squamous cell carcinoma. These parameters can reflect the level of PD-L1 expression to some extent.

Key words:

Esophageal squamous cell carcinoma, Positron emission tomography, ¹⁸F-fluoro-2-deoxy-D-glucose, Programmed cell death ligand-1

摘要：

目的　探讨食管鳞癌（ESCC）患者临床病理特征及¹⁸F-氟代脱氧葡萄糖（¹⁸F-FDG）正电子发射计算机体层显像仪（PET/CT）代谢参数与程序性死亡受体配体-1（PD-L1）表达的相关性。方法　回顾性分析2019年1月至2022年8月期间在揭阳市人民医院经手术治疗的91例ESCC患者临床病理特征及术前¹⁸F-FDG PET/CT检查资料。其中，男性66例，女性25例，中位年龄65岁，PD-L1表达阳性45例、阴性46例。分析患者性别、年龄、发病部位、肿瘤分化程度、神经束侵犯、脉管癌栓、T分期、N分期、TNM分期、原发灶最大标准摄取值（SUV_max）、代谢体积（MTV）、病灶糖酵解总量（TLG）与PD-L1表达水平的相关性。统计学方法采用Mann-Whitney U 非参数检验、χ²检验、Spearman相关分析及受试者操作特征曲线（ROC）。结果　ESCC T分期、SUV_max、TLG均与其PD-L1阳性存在正相关关系，相关系数r分别为0.215、0.297、0.264（均P<0.05）。ROC显示，SUV_max、TLG预测PD-L1阳性的曲线下面积（AUC）为0.671、0.623。结论　ESCC T分期及SUV_max、TLG与PD-L1表达水平存在相关性，可在一定程度上反映肿瘤的PD-L1表达情况。

关键词:

食管鳞癌, 正电子发射计算机体层显像仪, ¹⁸F-氟代脱氧葡萄糖, 程序性死亡受体配体-1