探讨通过整合2-[18F]-氟代脱氧-D-葡萄糖（FDG）正电子发射计算机断层扫描（PET/CT）评估的代谢参数与肺腺癌肿瘤微环境中免疫生物标志物表达的关联。本研究纳入了134名患者。代谢参数由PET/CT获得。采用免疫组化分析了FOXP3-TILs（转录因子forkhead box protein 3肿瘤浸润淋巴细胞）、CD8-TILs、CD4-TILs、CD68-TAMs（肿瘤相关巨噬细胞）和半乳糖凝集素1（Gal-1）肿瘤表达。FDG PET代谢参数与FOXP3-TILs和CD68-TAMs覆盖的中位数免疫反应区域（IRA％）显著正相关，但与CD8-TILs和CD4-TILs覆盖的中位数IRA％呈显著负相关。肿瘤Gal-1表达与FOXP3-TILs和CD68-TAMs覆盖的中位数IRA％呈显著正相关，而与CD8-TILs覆盖的中位数IRA％呈显著负相关。肿瘤分期（p = 0.008）、Gal-1表达（p = 0.008）和CD8-TILs覆盖的中位数IRA％（p = 0.054）是总体生存的独立危险因素。FDG PET可以促进肿瘤微环境的全面评估，并预测免疫治疗的响应。版权所有©2023 Elsevier Ltd.

To explore the association between metabolic parameters evaluated by integrated 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)/computed tomography (CT) and the expression of immune biomarkers in the tumour microenvironment in lung adenocarcinoma.This study included 134 patients. Metabolic parameters were obtained by PET/CT. Immunohistochemistry analysis was used for FOXP3-TILs (transcription factor forkhead box protein 3 tumour-infiltrating lymphocytes), CD8-TILs, CD4-TILs, CD68-TAMs (tumour-associated macrophages) and galectin-1 (Gal-1) tumour expression.There were significant positive associations between FDG PET metabolic parameters and the median percentage of immune reactive areas (IRA%) covered by FOXP3-TILs and CD68-TAMs. Negative associations with the median IRA% covered by CD4-TILs and CD8-TILs were observed: maximal standardised uptake value (SUVmax), metabolic tumour volume (MTV), total lesion glycolysis (TLG), and IRA% for FOXP3-TILs (rho = 0.437, 0.400, 0.414; p<0.0001 for all parameters); SUVmax, MTV, TLG, and IRA% for CD68-TAMs (rho = 0.356, 0.355, 0.354; p<0.0001 for all parameters); SUVmax, MTV, TLG, and IRA% for CD4-TILs (rho = -0.164, -0.190, -0.191; p=0.059, 0.028, 0.027, respectively); SUVmax, MTV, TLG, and IRA% for CD8-TILs (rho = -0.305, -0.316, -0.322; p<0.0001 for all parameters). There were significant positive associations between tumour Gal-1 expression and the median IRA% covered by FOXP3-TILs and CD68-TAMs (rho = 0.379; p<0.0001; rho = 0.370; p<0.0001, respectively), and a significant negative association with the median IRA% covered by CD8-TILs (rho = -0.347; p<0.0001) was observed. Tumour stage (p=0.008), Gal-1 expression (p=0.008), and median IRA% covered by CD8-TILs (p=0.054) were independent risk factors for overall survival.FDG PET may facilitate a comprehensive evaluation of the tumour microenvironment and predict response to immunotherapy.Copyright © 2023. Published by Elsevier Ltd.