Esteban-Rodríguez Isabel, Ruiz Bravo-Burguillos Elena, Rosas Rocio, Losantos Itsaso, Rodríguez-Antolín Carlos, de Castro Javier
Servicio de Anatomía Patológica, Hospital Universitario La Paz, Madrid, España; Grupo de Terapias Experimentales y Biomarcadores en Cáncer, IdiPAZ, Madrid, España.
Servicio de Anatomía Patológica, Hospital Universitario La Paz, Madrid, España.
Rev Esp Patol. 2020 Jan-Mar;53(1):10-18. doi: 10.1016/j.patol.2019.04.003. Epub 2019 Jul 2.
85% of lung cancers are non-small cell carcinomas (NSCLC), the majority of which are diagnosed in an advanced stage. Immunotherapy has changed the treatment pattern for these tumors and created the need to find a marker for patient selection. Although not ideal, PD-L1 is the biomarker currently used in clinical practice.
Retrospective review by two pathologists of 53 cases of NSCLC from 2005 to 2007 in Hospital Universitario La Paz, using the WHO 2015 classification studying PD-L1 with clones 22C3 and 28-8. The consistency between observers and clones was assessed and all data studied were correlated with survival rates.
We found a prevalence of PD-L1 expression in tumor cells (TC) similar to that previously reported in the literature and a very good consistency between clones in the evaluation of TC and immune cells (ICC 0.99-0.93, p<.001). Interobserver concordance was very good in the evaluation of TC (ICC 0.902, 95% CI: 0.836-0.942, p<.001 for clone 22C3 and ICC 0.927, 95% CI: 0.877-0.957, p<.001 for clone 28-8) and poor for immune cells (ICC of 0.413, 95% CI: 0.163-0.613, p=.001 with clone 22C3 and ICC of 0.313, 95% CI: 0.053-0.534, p=.010 with clone 28-8). Subtype and histological grade were the only variables related to prognosis.
The clones of PD-L1 22C3 and 28-8 are equivalent and there is good interobserver consistency in the evaluation of TC but not in immune cells.
85%的肺癌是非小细胞癌（NSCLC），其中大多数在晚期被诊断出来。免疫疗法改变了这些肿瘤的治疗模式，并产生了寻找患者选择标志物的需求。尽管并不理想，但PD-L1是目前临床实践中使用的生物标志物。
两位病理学家对2005年至2007年拉巴斯大学医院的53例NSCLC病例进行回顾性研究，采用世界卫生组织2015年分类，使用克隆号22C3和28-8研究PD-L1。评估观察者之间以及克隆之间的一致性，并将所有研究数据与生存率相关联。
我们发现肿瘤细胞（TC）中PD-L1表达的患病率与先前文献报道的相似，并且在评估TC和免疫细胞时克隆之间具有非常好的一致性（ICC 0.99 - 0.93，p <.001）。观察者间在评估TC时一致性非常好（克隆号22C3的ICC为0.902，95%可信区间：0.836 - 0.942，p <.001；克隆号28-8的ICC为0.927，95%可信区间：0.877 - 0.957，p <.001），而在评估免疫细胞时一致性较差（克隆号22C3的ICC为0.413，95%可信区间：0.163 - 0.613，p =.001；克隆号28-8的ICC为0.313，95%可信区间：0.053 - 0.534，p =.010）。亚型和组织学分级是与预后相关的唯一变量。
PD-L1的克隆号22C3和28-8等效，在评估TC时观察者间一致性良好，但在评估免疫细胞时并非如此。
