Most researchers believe that quantitative parameters of spectral CT imaging have certain advantages in the differential diagnosis of benign and malignant pulmonary nodules.15, 16, 17, 18, 19, 20, 21, 22, 23 There is no study testing the association between the spectral CT imaging parameters and the PD‐L1 expression in lung adenocarcinoma. Here, CD274 is linked to lung adenocarcinoma.