胃肿瘤中活检样本评估的 PD-L1 表达能否准确反映其在整个肿瘤中的表达？
Can PD-L1 expression evaluated by biopsy sample accurately reflect its expression in the whole tumour in gastric cancer?
机构信息
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
出版信息
Br J Cancer. 2019 Jul;121(3):278-280. doi: 10.1038/s41416-019-0515-5. Epub 2019 Jul 9.
Programmed death ligand 1 (PD-L1) expression as a predictive biomarker for programmed cell death 1 (PD-1) inhibitor efficacy in gastric cancer (GC) remains controversial. We hypothesised that the conflicting results may be due to the inaccurate assessment of PD-L1 expression using biopsy samples. A total of 191 patients with GC who received radical resection were enrolled. PD-L1 expressions in biopsy and paired resected samples by immunohistochemistry staining were compared according to the number of biopsies. The numbers of PD-L1-positive patients determined by biopsy and resected samples were 89 (46.6%) and 135 (70.1%), respectively. The accordance rate was 64.4% (κ = 0.31). Single biopsy showed a lower accordance rate compared with multiple biopsies. Our study revealed that single biopsy cannot fully reflect PD-L1 expression in the whole tumour in GC. Multiple biopsies are recommended for accurate diagnosis of PD-L1 expression in GC.
程序性死亡配体 1（PD-L1）表达作为预测生物标志物，用于评估程序性死亡 1（PD-1）抑制剂在胃癌（GC）中的疗效仍存在争议。我们假设，这种相互矛盾的结果可能是由于使用活检样本进行 PD-L1 表达的评估不准确所致。本研究共纳入 191 例接受根治性切除术的 GC 患者。根据活检数量比较免疫组化染色检测活检和配对切除样本中的 PD-L1 表达。活检和切除样本中 PD-L1 阳性患者的数量分别为 89 例（46.6%）和 135 例（70.1%）。一致性率为 64.4%（κ=0.31）。单活检的一致性率低于多活检。本研究表明，单活检不能完全反映 GC 中整个肿瘤的 PD-L1 表达。建议进行多次活检以准确诊断 GC 中的 PD-L1 表达。
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