Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, 200032, China.
J Cancer Res Clin Oncol. 2021 May;147(5):1547-1556. doi: 10.1007/s00432-020-03444-y. Epub 2020 Nov 16.
The study aimed to evaluate the clinicopathological and molecular profiles associated with programmed death ligand 1 (PD-L1) expression in non-small cell lung cell (NSCLC) in a large-scale, multi-center, real-world Chinese cohort.
A total of 6295 NSCLC specimens from six centers in China were analyzed by PD-L1 (22C3) assay. PD-L1 expression in tumor cells (TCs) was classified as negative (TPS expression in < 1% of TCs), low (TPS in 1-49% of TCs), or high (TPS in ≥ 50% of TCs). The status of EGFR mutation was determined by reverse transcription polymerase chain reaction or next-generation sequencing, and ALK and ROS1 translocation was analyzed by immunohistochemistry and fluorescence in situ hybridization. Associations of PD-L1 expression with clinicopathological features and driver mutations were analyzed.
Positive PD-L1 expression was more frequently seen in squamous cell carcinoma (SCC) and other histological types of NSCLC compared to adenocarcinoma (AC). In AC, PD-L1 expression was associated with gender, histological type, metastatic status, and pathological features of lymphovascular invasion and visceral pleural invasion. Solid and micropapillary subtypes of AC were more likely to have positive PD-L1 expression compared to other subtypes. PD-L1 was more highly expressed in biopsy samples than in resected samples, and in metastatic samples compared with primary tissues. PD-L1 expression was significantly associated with wild-type EGFR and ALK translocations.
PD-L1 expression in NSCLC is linked to histological type, pathological features, and driver mutation status, which has meaningful implications for clinical practice.
本研究旨在评估在中国大规模、多中心真实世界的队列中，非小细胞肺癌（NSCLC）中程序性死亡配体 1（PD-L1）表达的临床病理和分子特征。
对来自中国 6 个中心的 6295 例 NSCLC 标本进行 PD-L1（22C3）检测。肿瘤细胞（TCs）中 PD-L1 的表达分为阴性（TCs 中 PD-L1 表达<1%）、低表达（TCs 中 PD-L1 表达 1-49%）或高表达（TCs 中 PD-L1 表达≥50%）。EGFR 突变状态通过逆转录聚合酶链反应或下一代测序确定，ALK 和 ROS1 易位通过免疫组化和荧光原位杂交分析。分析 PD-L1 表达与临床病理特征和驱动突变的关系。
与腺癌（AC）相比，鳞状细胞癌（SCC）和其他组织学类型的 NSCLC 中阳性 PD-L1 表达更为常见。在 AC 中，PD-L1 表达与性别、组织学类型、转移状态以及血管淋巴管侵犯和内脏胸膜侵犯的病理特征有关。与其他亚型相比，AC 的实性和微乳头状亚型更有可能出现阳性 PD-L1 表达。活检标本中 PD-L1 的表达高于手术切除标本，转移标本中 PD-L1 的表达高于原发性组织。PD-L1 的表达与野生型 EGFR 和 ALK 易位显著相关。
NSCLC 中 PD-L1 的表达与组织学类型、病理特征和驱动突变状态有关，这对临床实践具有重要意义。
