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

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

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Our objective was to clarify the computed tomography features of programmed death-ligand 1 (PD-L1)–expressing lung adenocarcinomas. Among 394 patients, 78 (19.8%) were positive for PD-L1 expression. On multivariate analysis, the presence of convergence (P <.01) and cavitation (P <.01) and the absence of surrounding ground glass opacity (P =.02) and air bronchogram (P =.03) were shown to be significantly associated with PD-L1 expression. 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.

Original languageEnglish
Pages (from-to)e375-e383
JournalClinical Lung Cancer
Volume18
Issue number6
DOIs
Publication statusPublished - Nov 2017

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Fingerprint Dive into the research topics of 'Computed Tomography Features of Lung Adenocarcinomas With Programmed Death Ligand 1 Expression'. Together they form a unique fingerprint.

  • Cite this

    Toyokawa, G., Takada, K., Okamoto, T., Shimokawa, M., Kozuma, Y., Matsubara, T., Haratake, N., Takamori, S., Akamine, T., Katsura, M., Shoji, F., Oda, Y., & Maehara, Y. (2017). Computed Tomography Features of Lung Adenocarcinomas With Programmed Death Ligand 1 Expression. Clinical Lung Cancer, 18(6), e375-e383. https://doi.org/10.1016/j.cllc.2017.03.008