Radiological Features of Programmed Cell Death-Ligand 2-positive Lung Adenocarcinoma: A Single-institution Retrospective Study

In Vivo. 2018 Nov-Dec;32(6):1541-1550. doi: 10.21873/invivo.11412.

Abstract

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.

Keywords: CT; PD-L2; lung adenocarcinoma.

MeSH terms

  • Adenocarcinoma of Lung / diagnostic imaging
  • Adenocarcinoma of Lung / genetics*
  • Adenocarcinoma of Lung / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • B7-H1 Antigen / genetics*
  • Biomarkers, Tumor / genetics*
  • Female
  • Fluorodeoxyglucose F18 / administration & dosage
  • Gene Expression Regulation, Neoplastic / genetics
  • Humans
  • Male
  • Neoplasm Invasiveness / genetics
  • Neoplasm Invasiveness / pathology
  • Positron Emission Tomography Computed Tomography
  • Programmed Cell Death 1 Ligand 2 Protein / genetics*
  • Programmed Cell Death 1 Receptor / genetics

Substances

  • B7-H1 Antigen
  • Biomarkers, Tumor
  • CD274 protein, human
  • PDCD1 protein, human
  • PDCD1LG2 protein, human
  • Programmed Cell Death 1 Ligand 2 Protein
  • Programmed Cell Death 1 Receptor
  • Fluorodeoxyglucose F18