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Abstract：
BACKGROUND: The tumor microenvironment (TME) plays a crucial role in therapy response and modulation of immunologic surveillance. Adjuvant immunotherapy has recently been introduced in post-surgery treatment of locally advanced esophageal cancer (EC) with residual pathological disease after neoadjuvant chemoradiotherapy (nCRT). F-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) remains a valuable imaging tool to assess therapy response and to visualize metabolic TME; however, there is still a paucity in understanding the interaction between the TME and nCRT response. This systematic review investigated the potential of TME biomarkers and 18F-FDG-PET/CT features to predict pathological and clinical response (CR) after nCRT in EC.
METHODS: A literature search of the Medline and Embase electronic databases identified 4190 studies. Studies regarding immune and metabolic TME biomarkers and 18F-FDG-PET/CT features were included for predicting pathological response (PR) and/or CR after nCRT. Separate analyses were performed for 18F-FDG-PET/CT markers and these TME biomarkers.
RESULTS: The final analysis included 21 studies-10 about immune and metabolic markers alone and 11 with additional 18F-FDG-PET/CT features. High CD8 infiltration before and after nCRT, and CD3 and CD4 infiltration after nCRT, generally correlated with better PR. A high expression of tumoral or stromal programmed death-ligand 1 (PD-L1) after nCRT was generally associated with poor PR. Moreover, total lesion glycolysis (TLG) and metabolic tumor volume (MTV) of the primary tumor were potentially predictive for clinical and PR.
CONCLUSIONS: CD8, CD4, CD3, and PD-L1 are promising immune markers in predicting PR, whereas TLG and MTV are potential 18F-FDG-PET/CT features to predict clinical and PR after nCRT in EC.
METHODS: A literature search of the Medline and Embase electronic databases identified 4190 studies. Studies regarding immune and metabolic TME biomarkers and 18F-FDG-PET/CT features were included for predicting pathological response (PR) and/or CR after nCRT. Separate analyses were performed for 18F-FDG-PET/CT markers and these TME biomarkers.
RESULTS: The final analysis included 21 studies-10 about immune and metabolic markers alone and 11 with additional 18F-FDG-PET/CT features. High CD8 infiltration before and after nCRT, and CD3 and CD4 infiltration after nCRT, generally correlated with better PR. A high expression of tumoral or stromal programmed death-ligand 1 (PD-L1) after nCRT was generally associated with poor PR. Moreover, total lesion glycolysis (TLG) and metabolic tumor volume (MTV) of the primary tumor were potentially predictive for clinical and PR.
CONCLUSIONS: CD8, CD4, CD3, and PD-L1 are promising immune markers in predicting PR, whereas TLG and MTV are potential 18F-FDG-PET/CT features to predict clinical and PR after nCRT in EC.
摘要：
背景：肿瘤微环境（TME）在治疗反应和调节免疫监视中起着至关重要的作用。最近，辅助免疫疗法已被引入到局部晚期食管癌（EC）的术后治疗中，并在新辅助放化疗（nCRT）后残留病理疾病。F-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG-PET/CT）仍然是评估治疗反应和可视化代谢TME的有价值的成像工具；然而，对TME和nCRT反应之间的相互作用仍缺乏了解.这项系统评价研究了TME生物标志物和18F-FDG-PET/CT特征在预测ECnCRT后病理和临床反应（CR）方面的潜力。
方法：对Medline和Embase电子数据库的文献检索确定了4190项研究。包括关于免疫和代谢TME生物标志物和18F-FDG-PET/CT特征的研究，以预测nCRT后的病理反应（PR）和/或CR。对18F-FDG-PET/CT标志物和这些TME生物标志物进行单独分析。
结果：最终分析包括21项研究-10项仅涉及免疫和代谢标志物，11项具有其他18F-FDG-PET/CT特征。nCRT前后CD8高浸润，nCRT后CD3和CD4浸润，通常与更好的公关相关。nCRT后肿瘤或基质程序性死亡配体1（PD-L1）的高表达通常与PR差有关。此外，原发肿瘤的总病变糖酵解(TLG)和代谢性肿瘤体积(MTV)是临床和PR的潜在预测因素.
结论：CD8，CD4，CD3和PD-L1是预测PR的有希望的免疫标志物，而TLG和MTV是潜在的18F-FDG-PET/CT特征，可预测ECnCRT后的临床和PR。
方法：对Medline和Embase电子数据库的文献检索确定了4190项研究。包括关于免疫和代谢TME生物标志物和18F-FDG-PET/CT特征的研究，以预测nCRT后的病理反应（PR）和/或CR。对18F-FDG-PET/CT标志物和这些TME生物标志物进行单独分析。
结果：最终分析包括21项研究-10项仅涉及免疫和代谢标志物，11项具有其他18F-FDG-PET/CT特征。nCRT前后CD8高浸润，nCRT后CD3和CD4浸润，通常与更好的公关相关。nCRT后肿瘤或基质程序性死亡配体1（PD-L1）的高表达通常与PR差有关。此外，原发肿瘤的总病变糖酵解(TLG)和代谢性肿瘤体积(MTV)是临床和PR的潜在预测因素.
结论：CD8，CD4，CD3和PD-L1是预测PR的有希望的免疫标志物，而TLG和MTV是潜在的18F-FDG-PET/CT特征，可预测ECnCRT后的临床和PR。
