PDF(Pubmed)
Abstract：
To investigate the correlations between metabolic parameters (MPs) of 18 F-fluorodeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT), serum tumor markers (STMs), and tumor mutational burden (TMB) in patients with non-small cell lung cancer (NSCLC).
In this retrospective study, we enrolled 129 patients with NSCLC (males, 78; females, 51) who underwent baseline TMB and STM tests and 18 F-FDG PET/CT scans before treatment between March 2018 and September 2022. Patients were categorized into TMB-high (TMB ≥10 mutations/Mb; n = 27 [20.9%]) and non-TMB-high (TMB <10 mutations/Mb; n = 102 [79.1%]) groups. Binary logistic regression analyses were performed to determine independent predictors of TMB-high. Univariate and multivariate linear regression analyses were performed to determine independent predictors of TMB level on a log scale. Subgroup analyses for adenocarcinoma (ADC), ADC with EGFR+, ADC with EGFR-, and squamous cell carcinoma (SCC) were performed.
For ADC, all MPs (SULpeak , SULmax , SULmean , MTV, and TLG) were significantly higher in the TMB-high group than the non-TMB-high group; smoker (odds ratio [OR] = 27.08, p = 0.018), EGFR+ (OR = 0.03, p = 0.033), KRAS+ (OR = 7.98, p = 0.083), high CEA (OR = 33.56, p = 0.029), and high CA125 (OR = 13.68, p = 0.030) were independent predictors of TMB-high; and all MPs showed significant positive linear correlations with TMB on a log scale, with SULpeak as an independent predictor. However, no significant correlation was observed for SCC.
MPs and STMs can predict the TMB level for patients with ADC, and may serve as potential substitutes for TMB with increased value and easy implementation in guiding immunotherapy through noninvasive methods.
In this retrospective study, we enrolled 129 patients with NSCLC (males, 78; females, 51) who underwent baseline TMB and STM tests and 18 F-FDG PET/CT scans before treatment between March 2018 and September 2022. Patients were categorized into TMB-high (TMB ≥10 mutations/Mb; n = 27 [20.9%]) and non-TMB-high (TMB <10 mutations/Mb; n = 102 [79.1%]) groups. Binary logistic regression analyses were performed to determine independent predictors of TMB-high. Univariate and multivariate linear regression analyses were performed to determine independent predictors of TMB level on a log scale. Subgroup analyses for adenocarcinoma (ADC), ADC with EGFR+, ADC with EGFR-, and squamous cell carcinoma (SCC) were performed.
For ADC, all MPs (SULpeak , SULmax , SULmean , MTV, and TLG) were significantly higher in the TMB-high group than the non-TMB-high group; smoker (odds ratio [OR] = 27.08, p = 0.018), EGFR+ (OR = 0.03, p = 0.033), KRAS+ (OR = 7.98, p = 0.083), high CEA (OR = 33.56, p = 0.029), and high CA125 (OR = 13.68, p = 0.030) were independent predictors of TMB-high; and all MPs showed significant positive linear correlations with TMB on a log scale, with SULpeak as an independent predictor. However, no significant correlation was observed for SCC.
MPs and STMs can predict the TMB level for patients with ADC, and may serve as potential substitutes for TMB with increased value and easy implementation in guiding immunotherapy through noninvasive methods.
摘要：
目的：探讨18F-氟脱氧葡萄糖（FDG）摄取的代谢参数（MPs）在正电子发射断层扫描/计算机断层扫描（PET/CT）上的相关性。血清肿瘤标志物（STMs），非小细胞肺癌（NSCLC）患者的肿瘤突变负荷（TMB）。
方法：在这项回顾性研究中，我们纳入了129例NSCLC患者(男性，78；女性，51），在2018年3月至2022年9月期间，在治疗前进行了基线TMB和STM测试以及18F-FDGPET/CT扫描。患者分为TMB高（TMB≥10个突变/Mb;n=27[20.9%]）和非TMB高（TMB<10个突变/Mb;n=102[79.1%]）组。进行二元逻辑回归分析以确定TMB高的独立预测因子。进行单变量和多变量线性回归分析以在对数尺度上确定TMB水平的独立预测因子。腺癌（ADC）的亚组分析，ADC与EGFR+，带EGFR-的ADC,进行鳞状细胞癌（SCC）。
结果：对于ADC，所有议员(取消，SULmax,Sulmean,MTV,和TLG）在TMB高组明显高于非TMB高组；吸烟者（比值比[OR]=27.08，p=0.018），EGFR+（OR=0.03，p=0.033），KRAS+(OR=7.98,p=0.083),高CEA(OR=33.56，p=0.029)，高CA125（OR=13.68，p=0.030）是TMB高的独立预测因子；所有MPs在对数尺度上与TMB呈显著正线性相关，以SULpeak为独立预测因子。然而,对于SCC没有观察到显著的相关性.
结论：MPs和STMs可以预测ADC患者的TMB水平，并且可以作为TMB的潜在替代品，在通过非侵入性方法指导免疫治疗方面具有更高的价值和易于实施。
方法：在这项回顾性研究中，我们纳入了129例NSCLC患者(男性，78；女性，51），在2018年3月至2022年9月期间，在治疗前进行了基线TMB和STM测试以及18F-FDGPET/CT扫描。患者分为TMB高（TMB≥10个突变/Mb;n=27[20.9%]）和非TMB高（TMB<10个突变/Mb;n=102[79.1%]）组。进行二元逻辑回归分析以确定TMB高的独立预测因子。进行单变量和多变量线性回归分析以在对数尺度上确定TMB水平的独立预测因子。腺癌（ADC）的亚组分析，ADC与EGFR+，带EGFR-的ADC,进行鳞状细胞癌（SCC）。
结果：对于ADC，所有议员(取消，SULmax,Sulmean,MTV,和TLG）在TMB高组明显高于非TMB高组；吸烟者（比值比[OR]=27.08，p=0.018），EGFR+（OR=0.03，p=0.033），KRAS+(OR=7.98,p=0.083),高CEA(OR=33.56，p=0.029)，高CA125（OR=13.68，p=0.030）是TMB高的独立预测因子；所有MPs在对数尺度上与TMB呈显著正线性相关，以SULpeak为独立预测因子。然而,对于SCC没有观察到显著的相关性.
结论：MPs和STMs可以预测ADC患者的TMB水平，并且可以作为TMB的潜在替代品，在通过非侵入性方法指导免疫治疗方面具有更高的价值和易于实施。
