程序性死亡配体1（PD-L1）在肺多形性癌中的表达。
Programmed death-ligand 1 (PD-L1) expression in pleomorphic carcinoma of the lung.
作者信息
Imanishi Naoko, Hirai Ayako, Yoneda Kazue, Shimajiri Shohei, Kuwata Taiji, Tashima Yuko, Takeuchi Masahiro, Iwai Yoshiko, Ichiki Yoshinobu, Tanaka Fumihiro
机构信息
Second Department of Surgery (Chest Surgery), University of Occupational and Environmental Health, Kitakyushu, Japan.
Second Department of Pathology, University of Occupational and Environmental Health, Kitakyushu, Japan.
出版信息
J Surg Oncol. 2018 Jun;117(7):1563-1569. doi: 10.1002/jso.25041. Epub 2018 Mar 30.
BACKGROUND AND OBJECTIVES
Pulmonary pleomorphic carcinoma (PPC) is a rare and aggressive subtype of lung cancer. Programmed cell death-ligand 1 (PD-L1) expression may be induced in a variety of malignant tumors, but its prognostic implication in PPC remains unclear.
METHODS
Twenty-six patients with surgically resected PPC were retrospectively reviewed. Immuno-histochemical staining was used to detect PD-L1 expression, and PD-L1 status was classified into "high" or "low" according to the percentage of tumor cells (TCs) expressing PD-L1 (tumor proportion score, TPS).
RESULTS
PD-L1 expression was positive in 20 (76.9%) patients at the cut-off TPS value of 1%. A receiver-operating characteristic (ROC) analysis showed that the optimal cut-off value was 15% for prediction of cancer-specific death with the area under ROC curve of 0.701 (P = 0.107). High PD-L1 expression was associated with a favorable overall survival (88.9% vs 37.5% at 5 years; P =.046) as well as a favorable cancer-specific (100% vs 45.9% at 5 years; P =.012). A multivariate analysis indicated a trend toward a favorable prognosis associated with high PD-L1 expression (hazard ratio [HR], 0.254 [95% confidence interval, 0.054-1.200]; P = 0.084).
CONCLUSIONS
PD-L1 expression was positive in most PPC cases, and high PD-L1 expression may predict a favorable prognosis in resected PPC.
背景与目的
肺多形性癌（PPC）是一种罕见且侵袭性强的肺癌亚型。程序性细胞死亡配体1（PD-L1）表达可在多种恶性肿瘤中被诱导，但它在PPC中的预后意义仍不明确。
方法
回顾性分析26例接受手术切除的PPC患者。采用免疫组织化学染色检测PD-L1表达，并根据表达PD-L1的肿瘤细胞（TCs）百分比（肿瘤比例评分，TPS）将PD-L1状态分为“高”或“低”。
结果
在TPS临界值为1%时，20例（76.9%）患者的PD-L1表达呈阳性。受试者工作特征（ROC）分析显示，预测癌症特异性死亡的最佳临界值为15%，ROC曲线下面积为0.701（P = 0.107）。高PD-L1表达与良好的总生存期相关（5年时为88.9%对37.5%；P = 0.046）以及良好的癌症特异性生存期相关（5年时为100%对45.9%；P = 0.012）。多因素分析表明，高PD-L1表达与良好预后呈趋势相关（风险比[HR]，0.254[95%置信区间，0.054 - 1.200]；P = 0.084）。
结论
大多数PPC病例中PD-L1表达呈阳性，高PD-L1表达可能预示手术切除的PPC预后良好。
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