Miyazawa Tomoyuki, Marushima Hideki, Saji Hisashi, Kojima Koji, Hoshikawa Masahiro, Takagi Masayuki, Nakamura Haruhiko
Department of Chest Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Department of Clinical Regenerative Medicine and Tissue Engineering, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Ann Thorac Cardiovasc Surg. 2019 Feb 20;25(1):1-9. doi: 10.5761/atcs.oa.18-00163. Epub 2018 Oct 3.
Knowledge regarding programmed death-ligand 1 (PD-L1) expression in lung cancer is limited. We aim to clarify PD-L1-positive expression in non-small-cell lung cancer (NSCLC), including adenocarcinoma subtypes.
In all, 90 NSCLC specimens containing various adenocarcinoma subtypes, in addition to squamous cell carcinoma and large-cell carcinoma were selected. PD-L1 was immunohistochemically stained by murine monoclonal antibody clone 22C3.
When PD-L1-positive expression was defined by tumor proportion score (TPS) ≥1%, the positive cases were 0/11 in adenocarcinoma in situ, 0/12 in minimally invasive adenocarcinoma, 1/10 in lepidic predominant adenocarcinoma, 1/13 in papillary predominant adenocarcinoma, 8/14 in acinar predominant adenocarcinoma, 6/11 in solid predominant adenocarcinoma, 0/3 in micropapillary predominant adenocarcinoma, 0/4 in invasive mucinous adenocarcinoma, 4/9 in squamous cell carcinoma, and 2/3 in large-cell carcinoma. PD-L1 positivity was higher in males, smokers, advanced pathologic stages, positive vessel invasion, and positive lymphatic invasion. Postoperative survival analysis revealed that PD-L1-positive expression was a significantly worse prognostic factor in univariate analysis for recurrence-free survival (RFS).
PD-L1-positive tumors were frequent in acinar predominant adenocarcinoma and solid predominant adenocarcinoma than other adenocarcinoma subtypes. PD-L1 expression seemed to increase according to pathologic tumor progression, suggesting a worse postoperative prognosis in NSCLC patients.
关于肺癌中程序性死亡配体1（PD-L1）表达的知识有限。我们旨在阐明非小细胞肺癌（NSCLC）中PD-L1的阳性表达情况，包括腺癌亚型。
总共选取了90例NSCLC标本，其中除了鳞状细胞癌和大细胞癌外，还包含各种腺癌亚型。采用鼠单克隆抗体克隆22C3对PD-L1进行免疫组织化学染色。
当以肿瘤比例评分（TPS）≥1%定义PD-L1阳性表达时，原位腺癌中阳性病例为0/11，微浸润腺癌中为0/12，鳞屑状为主型腺癌中为1/10，乳头状为主型腺癌中为1/13，腺泡状为主型腺癌中为8/14，实体状为主型腺癌中为6/11，微乳头状为主型腺癌中为0/3，浸润性黏液腺癌中为0/4，鳞状细胞癌中为4/9，大细胞癌中为2/3。PD-L1阳性在男性、吸烟者、病理分期较晚、血管侵犯阳性和淋巴侵犯阳性的患者中更高。术后生存分析显示，在无复发生存期（RFS）的单因素分析中，PD-L1阳性表达是一个显著更差的预后因素。
与其他腺癌亚型相比，腺泡状为主型腺癌和实体状为主型腺癌中PD-L1阳性肿瘤更为常见。PD-L1表达似乎随着肿瘤病理进展而增加，提示NSCLC患者术后预后较差。
