可靠的预测标志物对于接受新辅助化免疫疗法的可切除非小细胞肺癌(NSCLC)患者缺乏。本研究调查了PET/CT获取的SUVmax值在预测可切除NSCLC接受新辅助化免疫疗法后的反应中的应用。SUVmax、临床和病理结果从五家医院的患者中收集。接受动态PET/CT监测的患者分为A组（化免疫疗法）和B组（化疗），而C组（化免疫疗法）则包括行治疗后PET/CT的患者。通过接收操作特征曲线（ROC）评估SUVmax和重要病理响应（MPR）之间的关联。共鉴定了129例病例，MPR率为46.5％。在新辅助化免疫疗法中，ΔSUVmax%（AUC：0.890，95％CI：0.761-0.949）和治疗后SUVmax（AUC：0.933，95％CI：0.802-0.959）可以准确预测MPR。相反，基线SUVmax与MPR无关（p = 0.184）。此外，独立的C组证实，治疗后SUVmax可以作为一个独立的预测因子（AUC：0.928，95％CI：0.823-0.958）。此外，当我们在新辅助化免疫疗法中使用ΔSUVmax％（54.4％，AUC：0.912，95％CI：0.824-0.994）和治疗后SUVmax的最佳切割点（3.565，AUC：0.912，95％CI：0.824-0.994）时，可以观察到强健的预测性能。RNA数据显示，在接受新辅助化免疫疗法后，PFKFB4的表达与SUVmax值和肿瘤细胞增殖呈正相关。这些发现强调了ΔSUVmax％和保留的SUVmax是预测新辅助化免疫疗法后MPR的准确、非侵入性测试。版权所有©2023 Elsevier B.V.。保留所有权利。

Reliable predictive markers are lacking for resectable non-small cell lung cancer (NSCLC) patients treated with neoadjuvant chemoimmunotherapy. The present study investigated the utility of SUVmax values acquired from PET/CT to predict the response to neoadjuvant chemoimmunotherapy for resectable NSCLC.SUVmax, clinical and pathological outcomes, were collected from patients in 5 hospitals. Patients who received dynamic PET/CT surveillance were divided into cohorts A (chemoimmunotherapy) and B (chemotherapy), respectively, while cohort C (chemoimmunotherapy) comprised patients undergoing post-therapy PET/CT. Associations between SUVmax and major pathologic response (MPR) were evaluated through receiver operating characteristic (ROC) curves.A total of 129 cases with an MPR rate of 46.5 % was identified. In neoadjuvant chemoimmunotherapy, ΔSUVmax% (AUC: 0.890, 95 % CI: 0.761-0.949) and post-therapy SUVmax (AUC: 0.933, 95 % CI: 0.802-0.959) could accurately predict MPR. On the contrary, the baseline SUVmax was not associated with MPR (p = 0.184). Furthermore, an independent cohort C proved that post-therapy SUVmax could serve as an independent predictor (AUC: 0.928, 95 % CI: 0.823-0.958). In addition, robust predictive performance could be observed when we use the optimal cut-off point of both ΔSUVmax% (54.4 %, AUC: 0.912, 95 % CI: 0.824-0.994) and post-therapy SUVmax (3.565, AUC: 0.912, 95 % CI: 0.824-0.994) in neoadjuvant chemoimmunotherapy. The RNA data revealed that the expression of PFKFB4, a key enzyme in glycolysis, was positively correlated with SUVmax value and tumor cell proliferation after neoadjuvant chemoimmunotherapy.These findings highlighted that the ΔSUVmax% and remained SUVmax were accurate and non-invasive tests for the prediction of MPR after neoadjuvant chemoimmunotherapy.Copyright © 2023 Elsevier B.V. All rights reserved.