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Radiological Features of Programmed Cell Death-Ligand 2-positive Lung Adenocarcinoma: A Single-institution
Kazuki Takada1,2, Gouji Toyokawa3, Koichi Azuma4
1Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan k_takada@surg2.med.kyushu-u.ac.jp.
Aim:
Programmed cell death-ligand 1 and 2 (PD-L1 and PD-L2) are ligands of the programmed cell death-1 (PD1) receptor. PD1/PD-L1 inhibitors have shown clinical efficacy in non-small cell lung cancer (NSCLC). However, relatively little is known about the expression of PD-L2, or its association with the clinicopathological features of NSCLC. Here, the radiological features of PD-L2-positive lung adenocarcinoma were evaluated.
Materials And Methods:
PD-L1 and PD-L2 expression were evaluated by immunohistochemical staining of surgically-resected specimens from 393 patients with primary lung adenocarcinoma who underwent preoperative thin-section computed tomography (CT), 222 of whom also underwent 18F-fluorodeoxyglucose positron-emission tomography/CT (18F-FDG-PET/CT).
Results:
Among the 393 specimens, 132 (33.6%) and 266 (67.7%) were positive for PD-L1 and PD-L2 expression, respectively. Multivariate analysis showed that the absence of surrounding ground glass opacity and the presence of air bronchogram were significantly associated with PD-L2 expression; however, there was no significant association between PD-L2 expression and the consolidation/tumor ratio. In 222 18F-FDG-PET/CT, the maximum standardized uptake value was significantly higher in patients with PD-L2-positive compared to those with PD-L2-negative tumors.
Conclusion:
PD-L2-positive lung adenocarcinomas are less radiologically malignant and invasive than their PD-L1-positive counterparts.
Insights
Programmed cell death-ligand 2 (PD-L2) expression in lung adenocarcinoma is common and associated with less aggressive radiological features. PD-L2-positive tumors show lower standardized uptake values on PET/CT scans.
Area of Science:
- Oncology
- Radiology
- Immunology
Background:
- Programmed cell death-1 (PD1) receptor ligands, PD-L1 and PD-L2, are crucial in cancer immunity.
- PD1/PD-L1 inhibitors are effective in non-small cell lung cancer (NSCLC).
- PD-L2 expression and its clinicopathological correlations in NSCLC remain underexplored.
Purpose of the Study:
- To evaluate the radiological features of PD-L2-positive lung adenocarcinoma.
- To investigate the association between PD-L2 expression and clinicopathological characteristics.
- To compare radiological findings of PD-L2-positive versus PD-L2-negative tumors.
Main Methods:
- Immunohistochemical staining for PD-L1 and PD-L2 on 393 lung adenocarcinoma specimens.
- Preoperative thin-section computed tomography (CT) for all patients.
- 18F-fluorodeoxyglucose positron-emission tomography/CT (18F-FDG-PET/CT) for 222 patients.
Main Results:
- PD-L2 expression was found in 67.7% of lung adenocarcinomas.
- Absence of surrounding ground glass opacity and presence of air bronchogram were linked to PD-L2 positivity.
- PD-L2-positive tumors exhibited significantly higher maximum standardized uptake values on 18F-FDG-PET/CT.
Conclusions:
- PD-L2-positive lung adenocarcinomas demonstrate less malignant and invasive radiological characteristics.
- Radiological features can help predict PD-L2 expression in lung adenocarcinoma.
- Further research into PD-L2's role in NSCLC is warranted.
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