Computed Tomography Features of Lung Adenocarcinomas With Programmed Death Ligand 1 Expression.

Abstract

INTRODUCTION:

The development of immune checkpoint inhibitors against programmed death 1 has paved the way for a new era of treatment of lung cancer. Programmed death-ligand 1 (PD-L1) is expected to predict the response of immune checkpoint inhibitors in lung cancer. Predicting PD-L1 expression using a noninvasive method before immunotherapy would, therefore, help identify patients for whom immunotherapy can be successful.

PATIENTS AND METHODS:

A total of 394 patients with resected lung adenocarcinoma who had undergone preoperative thin-section computed tomography (CT) were analyzed for PD-L1 expression by immunohistochemistry and evaluated to determine the association between PD-L1 expression and CT characteristics, including convergence, surrounding ground glass opacity (GGO), air bronchogram, notching, pleural indentation, spiculation, and cavitation.

RESULTS:

Of the 394 patients, 78 (19.8%) were positive and 316 (80.2%) were negative for PD-L1 expression. Univariate analysis demonstrated that PD-L1+ adenocarcinoma was significantly associated with the presence of convergence (P < .01), notching (P < .01), spiculation (P < .01), and cavitation (P < .01) and the absence of surrounding GGO (P < .01) compared with PD-L1- cases. On multivariate analysis, the presence of convergence (P < .01) and cavitation (P < .01) and the absence of surrounding GGO (P = .02) and air bronchogram (P = .03) were significantly associated with PD-L1 expression.

CONCLUSION:

PD-L1+ adenocarcinoma cases showed convergence and cavitation more frequently than did PD-L1- cases. In contrast, surrounding GGO and air bronchogram were observed less frequently in PD-L1+ cases than in PD-L1- cases. These results will prove helpful in identifying PD-L1-expressing adenocarcinoma by CT before immunotherapy.

• Authors: Gouji Toyokawa, Kazuki Takada, Tatsuro Okamoto, Mototsugu Shimokawa, Yuka Kozuma, Taichi Matsubara, Naoki Haratake, Shinkichi Takamori, Takaki Akamine, Masakazu Katsura, Fumihiro Shoji, Yoshinao Oda, Yoshihiko Maehara
• Journal: Clinical lung cancer (Clin Lung Cancer) Vol. 18 Issue 6 Pg. e375-e383 (11 2017) ISSN: 1938-0690 [Electronic] United States
• PMID: 28385373 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 Elsevier Inc. All rights reserved.

Chemical References

• B7-H1 Antigen
• CD274 protein, human

Topics

• Adenocarcinoma (diagnostic imaging, genetics, surgery)
• Adenocarcinoma of Lung
• Adult
• Aged
• Aged, 80 and over
• B7-H1 Antigen (genetics)
• Female
• Gene Expression Regulation, Neoplastic
• Humans
• Immunohistochemistry
• Immunotherapy (methods)
• Lung Neoplasms (diagnostic imaging, genetics, surgery)
• Male
• Middle Aged
• Multivariate Analysis
• Tomography, X-Ray Computed (methods)