Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Thorac Cancer. 2019 Feb;10(2):175-182. doi: 10.1111/1759-7714.12929. Epub 2018 Dec 11.
PD-L1 expression in tumor cells has been associated with the efficacy of immune checkpoint inhibitors in non-small cell lung cancer (NSCLC). The aim of this study was to explore correlations between smoking, genetic profiles, patient outcomes, and PD-L1 expression in NSCLC.
PD-L1 expression was evaluated in 241 surgically resected specimens by immunostaining and 50% was set as the cutoff value.
Of the 241 tumors analyzed, a PD-L1 tumor proportion score (TPS) of ≥ 50% was detected in 35 cases (14.5%) and a TPS of < 50% in 206 cases (85.5%). A PD-L1 TPS ≥ 50% was significantly associated with smoking and EGFR wild-type status (P < 0.001 and P = 0.039, respectively). Detailed assessment of smoking variables showed that total smoking duration was a predictor of a PD-L1 TPS ≥ 50% (P = 0.001). Univariate and multivariate survival analyses revealed that patients with a PD-L1 TPS ≥ 50% had poorer disease-free and overall survival than those with a PD-L1 TPS < 50% (P = 0.001 and P < 0.001, respectively).
The incidence of a PD-L1 TPS ≥ 50% was significantly higher in smoking and EGFR wild-type NSCLC patients, particularly in long-term smokers. A PD-L1 TPS of ≥ 50% was an independent adverse prognostic factor for survival in patients with NSCLC.
肿瘤细胞中 PD-L1 的表达与非小细胞肺癌（NSCLC）中免疫检查点抑制剂的疗效相关。本研究旨在探讨 NSCLC 中吸烟、遗传特征、患者结局与 PD-L1 表达之间的相关性。
通过免疫染色评估 241 例手术切除标本中的 PD-L1 表达，以 50%作为截断值。
在分析的 241 个肿瘤中，有 35 个（14.5%）肿瘤的 PD-L1 肿瘤比例评分（TPS）≥50%，206 个（85.5%）肿瘤的 TPS＜50%。PD-L1 TPS≥50%与吸烟和 EGFR 野生型状态显著相关（P＜0.001 和 P=0.039）。对吸烟变量的详细评估显示，总吸烟量是 PD-L1 TPS≥50%的预测因素（P=0.001）。单因素和多因素生存分析显示，PD-L1 TPS≥50%的患者无病生存和总生存均较 PD-L1 TPS＜50%的患者差（P=0.001 和 P＜0.001）。
在吸烟和 EGFR 野生型 NSCLC 患者中，PD-L1 TPS≥50%的发生率显著更高，尤其是在长期吸烟者中。PD-L1 TPS≥50%是 NSCLC 患者生存的独立不良预后因素。
