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Research Paper|Volume 11, Issue 24|pp 12270—12277

Relationship between PD-L1 expression and 18F-FDG uptake in gastric cancer

Ruohua Chen1, Yumei Chen1, Gang Huang2, Jianjun Liu1
  • 1Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
  • 2Shanghai University of Medicine and Health Sciences, Shanghai, China
* Equal contribution
Received: October 17, 2019Accepted: November 20, 2019Published: December 17, 2019
https://doi.org/10.18632/aging.102567

Copyright © 2019 Chen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Purpose: Immunotherapy has been successfully utilized for treatment of gastric cancer, so the identification of clinicopathologic features that are predictive of response to this therapy is crucial. 18F-FDG PET/CT can provide information on the molecular phenotype of many malignant tumors. The correlation between 18F-FDG accumulation and PD-L1/PD-L1-TILs status in gastric cancer patients has not been investigated. The aim of the current study is to assess whether 18F-FDG accumulation is associated with PD-L1/PD-L1-TILs status, and whether 18F-FDG PET/CT may be useful for predicting PD-L1/PD-L1-TILs expression of gastric cancer.

Results: Tumors with positive PD-L1 expression had higher SUVmax than in tumors with negative PD-L1 expression (15.0 ± 8.0 vs. 7.2 ± 4.2, respectively; P = 0.004). Tumors with positive PD-L1-TILs expression also had higher SUVmax than in tumors with negative PD-L1-TILs expression (10.3 ± 6.5 vs. 6.6 ± 3.7, respectively; P = 0.034). Multivariate analysis suggested that SUVmax remained significantly correlated with the status of PD-L1 (P = 0.043) and PD-L1-TILs (P = 0.016). PD-L1 expression was predicted with an accuracy of 67.2% when a SUVmax value of 8.55 was used as a cutoff point for analysis. Similarly, PD-L1-TILs expression was predicted with an accuracy of 64.2%, when a SUVmax value of 7.9 was used as the threshold for analysis.

Conclusion: Higher 18F-FDG accumulation in gastric cancers is correlated with positive PD-L1/PD-L1-TILs expression. 18F-FDG PET/CT may be used to predict the status of PD-L1/PD-L1-TILs and thus aid in optimal treatment decision.

Methods: A retrospective analysis was conducted on 64 patients with gastric cancer who underwent 18F-FDG PET/CT. SUVmax was calculated from the 18F-FDG accumulation of the primary tumor. The relationship between SUVmax and PD-L1/PD-L1-TILs status was analyzed.