Fernández-Trujillo Liliana, Garcia-Robledo Juan E, Zúñiga-Restrepo Valeria, Sua Luz F
Department of Internal Medicine, Pulmonology Service, Interventional Pulmonology, Fundación Valle del Lili, Cali, Colombia.
Faculty of Health Sciences, Universidad Icesi, Cali, Colombia.
Respir Med Case Rep. 2020 May 31;30:101114. doi: 10.1016/j.rmcr.2020.101114. eCollection 2020.
Squamous cell lung carcinoma(SCLC), accounts for 20% of lung cancer(LC). The binding of programmed cell death 1(PD-1) to its ligand PD-L1 is a key checkpoint regulator of immune response, and overexpression of the latter leads to immune surveillance escape. This might represent an important oncogenic mechanism, as well as a predictor for immunotherapy treatment success in SCLC.
A retrospective series of 24 patients with SCLC was included(2009-2013). These patients presented with a single pulmonary lesion and no history of previous cancer. Expression of PD-L1 was evaluated on tumoral biopsies with immunohistochemistry. PD-L1 tumor proportion score(TPS) was considered high when ≥50%. Clinical characteristics regarding diagnosis were reviewed and recorded. Data were analysed in STATA v.14®.
Twenty four patients were included in this series. Mean age was 67 + 14 years, and 62.5% were men. Smoking status was positive in 54%. Cancer stage IV was present in 54%. PD-L1 was positive in 13(54%). (+)PD-L1 was more frequent in smokers than in non-smokers(11 vs 2)(p = 0.001), as well as in COPD patients(p = 0.006). General overall survival was 21.8% at 5 years. Overall survival at one year in PD-L1(+) was 30.7% and 72.7% for PD-L1(-) patients. Survival median for PD-L1(+) patients was 10.5mo, as well as for the whole series.
Patients with primary SCLC who have a high PD-L1 TPS, had a worse overall survival than their counterparts. PD-L1 expression in SCLC in a Colombian sample lies between the one found in the literature.
肺鳞状细胞癌（SCLC）占肺癌（LC）的20%。程序性细胞死亡蛋白1（PD-1）与其配体PD-L1的结合是免疫反应的关键检查点调节因子，后者的过表达导致免疫监视逃逸。这可能是一种重要的致癌机制，也是SCLC免疫治疗成功的预测指标。
纳入24例SCLC患者的回顾性系列研究（2009 - 2013年）。这些患者表现为单一肺部病变且无既往癌症病史。通过免疫组织化学在肿瘤活检组织上评估PD-L1的表达。当PD-L1肿瘤比例评分（TPS）≥50%时被认为是高表达。回顾并记录有关诊断的临床特征。在STATA v.14®中进行数据分析。
本系列研究纳入24例患者。平均年龄为67±14岁，62.5%为男性。54%的患者吸烟状况为阳性。54%的患者为癌症IV期。13例（54%）患者PD-L1呈阳性。PD-L1（+）在吸烟者中比非吸烟者更常见（11例对2例）（p = 0.001），在慢性阻塞性肺疾病（COPD）患者中也更常见（p = 0.006）。5年总体生存率为21.8%。PD-L1（+）患者1年总体生存率为30.7%，PD-L1（-）患者为72.7%。PD-L1（+）患者的生存中位数为10.5个月，整个系列也是如此。
PD-L1 TPS高的原发性SCLC患者的总体生存率低于其对应患者。哥伦比亚样本中SCLC的PD-L1表达水平介于文献报道之间。
