Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Ann Thorac Surg. 2018 Jun;105(6):1621-1626. doi: 10.1016/j.athoracsur.2018.01.081. Epub 2018 Mar 3.
Immune checkpoint inhibitors that target the programmed cell death protein ligand 1 (PD-L1) pathway have shown benefit for the treatment of metastatic non-small cell lung cancer (NSCLC). However, the prognostic value of PD-L1 independent of immunotherapy is still unclear, with conflicting results reported between PD-L1 expression and patient survival. Our aim was to correlate PD-L1 mRNA level with clinical and pathologic factors and to investigative the prognostic value of PD-L1 mRNA in all stages of NSCLC.
Gene expression and clinical data were obtained from public repositories in The Cancer Genome Atlas from the National Cancer Institute. Genotype-Tissue Expression was used to compare with normal tissue expression analysis.
A total of 985 patients met inclusion criteria, among whom 79.6% were stage I to II, 16.5% were stage III, and 3.5% were stage IV, representing 495 adenocarcinoma and 490 squamous cell carcinoma (SCC). PD-L1 mRNA gene expression in lung cancers was higher than in most other tumor and normal tissue types and was significantly higher in lung SCC than adenocarcinoma (p < 0.001). PD-L1 mRNA expression was associated with pathologic stage in SCC and with smoking status in adenocarcinoma of the lung. However, none of the cutoff values of PD-L1 mRNA expression were prognostic of overall survival.
Our results suggest that the value of PD-L1 mRNA in prognosticating outcome in lung cancer is limited. Further studies are needed to identify novel prognostic biomarkers other than PD-L1 that are associated with improved patient survival. Identification of further prognostically important biomarkers may prove useful in identifying patients suitable for immunotherapy.
针对程序性死亡配体 1（PD-L1）途径的免疫检查点抑制剂已显示出对转移性非小细胞肺癌（NSCLC）治疗的益处。然而，PD-L1 独立于免疫疗法的预后价值尚不清楚，PD-L1 表达与患者生存之间的结果存在冲突。我们的目的是将 PD-L1mRNA 水平与临床和病理因素相关联，并研究 PD-L1mRNA 在 NSCLC 所有阶段的预后价值。
从美国国立癌症研究所的癌症基因组图谱的公共存储库中获取基因表达和临床数据。组织表达基因型用于与正常组织表达分析进行比较。
共有 985 名患者符合纳入标准，其中 79.6%为 I 期至 II 期，16.5%为 III 期，3.5%为 IV 期，代表 495 例腺癌和 490 例鳞状细胞癌（SCC）。肺癌中 PD-L1mRNA 基因表达高于大多数其他肿瘤和正常组织类型，且肺 SCC 明显高于腺癌（p<0.001）。PD-L1mRNA 表达与 SCC 的病理分期相关，与肺腺癌的吸烟状态相关。然而，PD-L1mRNA 表达的任何截断值均与总生存期无关。
我们的结果表明，PD-L1mRNA 在预测肺癌患者预后中的价值有限。需要进一步的研究来确定与改善患者生存相关的除 PD-L1 以外的新的预后生物标志物。确定进一步具有预后意义的生物标志物可能有助于识别适合免疫治疗的患者。
