Yoon Nara, Kim Jiyoung, Maeng Lee-So, Ahn Joong Hyun, Park Eun Su
Department of Pathology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.
Anticancer Res. 2018 Oct;38(10):6003-6008. doi: 10.21873/anticanres.12949.
BACKGROUND/AIM: In patients with non-small cell lung cancer, relationships between PD-L1 (programmed death-ligand 1) expression and clinicopathological characteristics have been examined. However, the association between cytological features and PD-L1 expression remains unknown. Thus, the aim of this study was to investigate whether nuclear features might be correlated with PD-L1 expression in patients with advanced and inoperable lung adenocarcinoma using small biopsy specimens.
Archived slides from 90 patients with lung adenocarcinoma who underwent small biopsy between October 2014 and May 2017 at the Incheon St. Mary's Hospital, were reviewed. PD-L1 expression was detected by immunohistochemistry using PD-L1 22C3 IHC assay. Associations of PD-L1 expression with pathological and molecular features (EGFR mutation, ALK and ROS-1 rearrangement) were statistically analyzed.
PD-L1 expression in tumor cells was positive in 33 of 90 cases (36.7%). Higher PD-L1 expression (≥50%) was more frequent in cases with marked nuclear pleomorphism (p<0.001), coarse chromatin pattern (p=0.006), predominant nucleoli (≥3 μm) (p<0.001), large nuclear diameter (>5× small lymphocyte) (p=0.006), non-glandular feature (p<0.001), and atypical mitosis (p=0.034). There were no significant correlations between PD-L1 positivity and molecular features. In multivariable logistic regression analysis, PD-L1 positivity was independently associated with prominent nucleoli (p=0.005) and non-glandular feature (p=0.007).
Prominent nucleoli and non-glandular feature are independent predictors of PD-L1 expression in lung adenocarcinoma.
背景/目的：在非小细胞肺癌患者中，已对程序性死亡配体1（PD-L1）表达与临床病理特征之间的关系进行了研究。然而，细胞学特征与PD-L1表达之间的关联仍不清楚。因此，本研究的目的是使用小活检标本调查晚期不可手术切除的肺腺癌患者的核特征是否与PD-L1表达相关。
回顾了2014年10月至2017年5月在仁川圣母医院接受小活检的90例肺腺癌患者的存档玻片。使用PD-L1 22C3免疫组化检测法通过免疫组化检测PD-L1表达。对PD-L1表达与病理和分子特征（表皮生长因子受体（EGFR）突变、间变性淋巴瘤激酶（ALK）和原癌基因酪氨酸蛋白激酶ROS1（ROS-1）重排）之间的关联进行统计学分析。
90例病例中有33例（36.7%）肿瘤细胞中的PD-L1表达呈阳性。在具有明显核多形性（p<0.001）、粗糙染色质模式（p=0.006）、主要核仁（≥3μm）（p<0.001）、大核直径（>5×小淋巴细胞）（p=0.006）、非腺性特征（p<0.001）和非典型有丝分裂（p=0.034）的病例中，较高的PD-L1表达（≥50%）更为常见。PD-L1阳性与分子特征之间无显著相关性。在多变量逻辑回归分析中，PD-L1阳性与显著核仁（p=0.005）和非腺性特征（p=0.007）独立相关。
显著核仁和非腺性特征是肺腺癌中PD-L1表达的独立预测因素。
