Kumar Manish, Guleria Bhupesh, Swamy Shivashankar, Soni Sneha
Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India.
Assistant Professor, Community Medicine, Rama Medical College, Hapur, Uttar Pradesh, India.
Lung India. 2020 Mar-Apr;37(2):145-150. doi: 10.4103/lungindia.lungindia_488_19.
The aim of this study is to evaluate the incidence of programmed cell death-ligand 1 (PD-L1) expression in non-small cell lung cancer (NSCLC) cases and its correlation with gene mutation and clinicopathological parameters.
Samples from NSCLCs patients were studied for PD-L1 expression through immunohistochemistry (IHC) using Rabbit anti-human PDL-1/CD274 Monoclonal Antibody. Genetic mutations were studied using IHC/fluorescence in situ hybridization (FISH) methods (for anaplastic lymphoma kinase [ALK]) or polymerase chain reaction/gene sequencing analysis (for epidermal growth factor receptor [EGFR]). Pearson's correlation coefficient (r) was used for correlation analysis. PD-L1 expression was analyzed for association with clinicopathological features.
Of the 101 NSCLC cases, PD-L1 expression was observed in 33.66% (34/101) cases; tumor proportion score of <50%: 67.65% (23/34) and ≥50%: 32.35% (11/34) cases. PD-L1 positivity was seen in; males: 35.5%, females: 28%, smokers: 37.7%, cases with brain metastasis: 20%, cases with pleural effusion: 20.8%, and histopathological evaluation (well-differentiated: 21.42%, moderately-differentiated: 13.79%, poorly-differentiated: 36.11%, and adenosquamous disease: 40.9%). Genetic mutation studies revealed PD-L1 positivity in 18.1% cases with EGFR mutation, 50% of ALK-IHC positive cases, and 33.3% ALK-FISH positive cases. No or very weak correlation (r < 0.3) in PD-L1 expression with gene mutations or clinicopathological parameters was observed.
The study demonstrated PD-L1 expression in ~ 1/3 cases of NSCLC patients. No or very weak correlation was observed for PD-L1 expression with genetic mutations and other parameters studied. The presence of gene mutations in PD-L1 expressed samples suggests further investigation on PD-L1 inhibitors in such patients for decisive treatments.
本研究旨在评估程序性细胞死亡配体1（PD-L1）在非小细胞肺癌（NSCLC）病例中的表达发生率及其与基因突变和临床病理参数的相关性。
使用兔抗人PDL-1/CD274单克隆抗体，通过免疫组织化学（IHC）对NSCLC患者的样本进行PD-L1表达研究。使用IHC/荧光原位杂交（FISH）方法（用于间变性淋巴瘤激酶[ALK]）或聚合酶链反应/基因测序分析（用于表皮生长因子受体[EGFR]）研究基因突变。采用Pearson相关系数（r）进行相关性分析。分析PD-L1表达与临床病理特征的关联。
在101例NSCLC病例中，33.66%（34/101）的病例观察到PD-L1表达；肿瘤比例评分<50%：67.65%（23/34），≥50%：32.35%（11/34）。PD-L1阳性见于：男性：35.5%，女性：28%，吸烟者：37.7%，有脑转移的病例：20%，有胸腔积液的病例：20.8%，以及组织病理学评估（高分化：21.42%，中分化：13.79%，低分化：36.11%，腺鳞癌：40.9%）。基因突变研究显示，18.1%的EGFR突变病例、50%的ALK-IHC阳性病例和33.3%的ALK-FISH阳性病例中PD-L1呈阳性。未观察到PD-L1表达与基因突变或临床病理参数之间存在显著或非常弱的相关性（r<0.3）。
该研究表明约1/3的NSCLC患者存在PD-L1表达。未观察到PD-L1表达与所研究的基因突变和其他参数之间存在显著或非常弱的相关性。在表达PD-L1的样本中存在基因突变，提示对此类患者的PD-L1抑制剂进行进一步研究以确定治疗方案。
