Metabolic activity of extranodal NK/T cell lymphoma on 18F-FDG PET/CT according to immune subtyping

Abstract Disseminated extranodal NK/T cell lymphoma (ENKTL) is associated with dismal prognosis. Hence, distinct tumor immune microenvironment (TIME) subtypes were proposed to explain their influence on ENKTL progression and help predict treatment response. In this study, we investigated the capacit...

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Autores principales:	Chae Hong Lim, Sang Eun Yoon, Seok Jin Kim, Junhun Cho, Young Hyeh Ko, Kyung-Han Lee, Won Seog Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bd0cf9e0795f4c328e267732b5554438
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spelling	oai:doaj.org-article:bd0cf9e0795f4c328e267732b55544382021-12-02T16:30:05ZMetabolic activity of extranodal NK/T cell lymphoma on 18F-FDG PET/CT according to immune subtyping10.1038/s41598-021-85332-02045-2322https://doaj.org/article/bd0cf9e0795f4c328e267732b55544382021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85332-0https://doaj.org/toc/2045-2322Abstract Disseminated extranodal NK/T cell lymphoma (ENKTL) is associated with dismal prognosis. Hence, distinct tumor immune microenvironment (TIME) subtypes were proposed to explain their influence on ENKTL progression and help predict treatment response. In this study, we investigated the capacity of FDG PET/CT to discern ENKTL TIME subtypes. A total of 108 pretreatment FDG PET/CT scans of 103 patients with newly diagnosed or relapsed ENKTL were retrospectively analyzed. TIME subtype was determined using three key immunohistochemical markers. SUVmax, MTV and TLG were measured, and metabolic features associated with TIME subtype were statistically extracted. TIME subtype was immune tolerance (IT) in 13.9%, immune evasion A (IE-A) in 56.5%, immune evasion B (IE-B) in 21.3%, and immune silenced (IS) in 8%. The IS group showed the highest SUVmax (15.9 ± 6.4, P = 0.037), followed by IE-A (14.1 ± 7.8), IE-B (10.9 ± 5.6), and IT groups (9.6 ± 5.1). Among 53 with only nasal FDG lesions, 52 had non-IS subtype. Among 55 with extra-nasal FDG lesions, those with IS subtype more often had adrenal (P = 0.001) or testis involvement (P = 0.043), greater MTV (P = 0.005), greater TLG (P = 0.005), and SUVmax located at extra-nasal sites. The presence of 0–2 and 3–4 of these four findings was associated with low probability (2/46) and high probability (6/9) of IS subtype, respectively. Furthermore, patients showing IS subtype-favoring PET/CT pattern had worse overall survival compared to their counterparts. These results demonstrate that FDG PET/CT can help predict immune subtype in ENKTL patients. The different patterns between glycolytic activity and involved site according to TIME subtype might be related to the interplay between tumor cells and immune cells in the tumor microenvironment.Chae Hong LimSang Eun YoonSeok Jin KimJunhun ChoYoung Hyeh KoKyung-Han LeeWon Seog KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chae Hong Lim Sang Eun Yoon Seok Jin Kim Junhun Cho Young Hyeh Ko Kyung-Han Lee Won Seog Kim Metabolic activity of extranodal NK/T cell lymphoma on 18F-FDG PET/CT according to immune subtyping
description	Abstract Disseminated extranodal NK/T cell lymphoma (ENKTL) is associated with dismal prognosis. Hence, distinct tumor immune microenvironment (TIME) subtypes were proposed to explain their influence on ENKTL progression and help predict treatment response. In this study, we investigated the capacity of FDG PET/CT to discern ENKTL TIME subtypes. A total of 108 pretreatment FDG PET/CT scans of 103 patients with newly diagnosed or relapsed ENKTL were retrospectively analyzed. TIME subtype was determined using three key immunohistochemical markers. SUVmax, MTV and TLG were measured, and metabolic features associated with TIME subtype were statistically extracted. TIME subtype was immune tolerance (IT) in 13.9%, immune evasion A (IE-A) in 56.5%, immune evasion B (IE-B) in 21.3%, and immune silenced (IS) in 8%. The IS group showed the highest SUVmax (15.9 ± 6.4, P = 0.037), followed by IE-A (14.1 ± 7.8), IE-B (10.9 ± 5.6), and IT groups (9.6 ± 5.1). Among 53 with only nasal FDG lesions, 52 had non-IS subtype. Among 55 with extra-nasal FDG lesions, those with IS subtype more often had adrenal (P = 0.001) or testis involvement (P = 0.043), greater MTV (P = 0.005), greater TLG (P = 0.005), and SUVmax located at extra-nasal sites. The presence of 0–2 and 3–4 of these four findings was associated with low probability (2/46) and high probability (6/9) of IS subtype, respectively. Furthermore, patients showing IS subtype-favoring PET/CT pattern had worse overall survival compared to their counterparts. These results demonstrate that FDG PET/CT can help predict immune subtype in ENKTL patients. The different patterns between glycolytic activity and involved site according to TIME subtype might be related to the interplay between tumor cells and immune cells in the tumor microenvironment.
format	article
author	Chae Hong Lim Sang Eun Yoon Seok Jin Kim Junhun Cho Young Hyeh Ko Kyung-Han Lee Won Seog Kim
author_facet	Chae Hong Lim Sang Eun Yoon Seok Jin Kim Junhun Cho Young Hyeh Ko Kyung-Han Lee Won Seog Kim
author_sort	Chae Hong Lim
title	Metabolic activity of extranodal NK/T cell lymphoma on 18F-FDG PET/CT according to immune subtyping
title_short	Metabolic activity of extranodal NK/T cell lymphoma on 18F-FDG PET/CT according to immune subtyping
title_full	Metabolic activity of extranodal NK/T cell lymphoma on 18F-FDG PET/CT according to immune subtyping
title_fullStr	Metabolic activity of extranodal NK/T cell lymphoma on 18F-FDG PET/CT according to immune subtyping
title_full_unstemmed	Metabolic activity of extranodal NK/T cell lymphoma on 18F-FDG PET/CT according to immune subtyping
title_sort	metabolic activity of extranodal nk/t cell lymphoma on 18f-fdg pet/ct according to immune subtyping
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/bd0cf9e0795f4c328e267732b5554438
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Metabolic activity of extranodal NK/T cell lymphoma on 18F-FDG PET/CT according to immune subtyping

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