Background Recurrence and metastasis in patients with surgical treatment of lung adenocarcinoma are important factors affecting prognosis. Clinical trials have shown that immunocheckpoint inhibitors can benefit patients in the treatment of complete resected non-small cell lung cancer, and the use of imaging features to identifying the appropriate population for this treatment is worthy of investigation.
Objective To explore the correlation between preoperative CT imaging characteristics and PD-L1 expression detected postoperatively in complete resected lung adenocarcinoma, so as to provide imaging evidences for immunotherapy selection.
Methods From January to March in 2021, patients with invasive lung adenocarcinoma who underwent surgical resection in the Department of Thoracic Surgery of the First Medical Center of Chinese PLA General Hospital were included, and PD-L1 expression was divided into negative group (TPS<1%) and positive group (TPS≥1%) with a cut-off value of tumor proportion score (TPS)=1%. The clinical and imaging data of two groups were analyzed. Binary logistic regression analysis was used to detect factors that had a correlation effect on PD-L1 expression and ROC curve was used to evaluate its efficacy.
Results A total of 308 lesions from 306 patients were enrolled, of which 136 lesions were in positive group and 172 in negative group. Univariate analysis showed that male, smoking history, family history of lung cancer, lesion density, CTR, mean CT value, the maximum diameter, spiculation and pleural indentation were correlated with PD-L1 expression. Multivariate analysis showed that family history of lung cancer (OR=2.876, 95%CI: 1.257-6.578) and CTR value (OR=4.321, 95%CI:1.165-16.036) were closely correlated with PD-L1 expression, and AUC of the regression model was 0.682, with a sensitivity of 64.7% and a specificity of 69.2%.
Conclusion The family history of lung cancer and CTR are significantly correlated factors for PD-L1 expression of completely resected lung adenocarcinoma.
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