Amemiya Ryosuke, Miyoshi Tomohiro, Aokage Keiju, Suzuki Jun, Hoshino Hironobu, Udagawa Hibiki, Tane Kenta, Sugano Masato, Kojima Motohiro, Fujii Satoshi, Kuwata Takeshi, Ochiai Atsushi, Goto Koichi, Ikeda Norihiko, Tsuboi Masahiro, Ishii Genichiro
Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan; Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Kashiwa, Japan; Departments of Surgery, Tokyo Medical University, Tokyo, Japan.
Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Lung Cancer. 2021 Mar;153:56-65. doi: 10.1016/j.lungcan.2021.01.007. Epub 2021 Jan 8.
Pulmonary pleomorphic carcinoma (PC) is a rare non-small cell lung carcinoma (NSCLC) and is characterized by sarcomatoid and NSCLC components. This study aimed to characterize the association between immune microenvironmental factors and clinicopathological characteristics of PC.
Eighty consecutive PC patients who had undergone complete surgical resection were enrolled. We calculated the immunohistochemical staining scores for E-cadherin, vimentin, programmed death ligand 1 (PD-L1), and carbonic anhydrase IX in cancer cells and counted the numbers of CD204-positive tumor-associated macrophages (TAMs) and Foxp3-, CD8-, and CD20-positive tumor-infiltrating lymphocytes (TILs). We also examined the association between these scores and the prognostic outcomes.
The staining score for PD-L1 in cancer cells and the number of CD204-positive TAMs in the sarcomatoid component were significantly higher than those in the NSCLC component; E-cadherin score in the sarcomatoid component was significantly lower. Patients with high PD-L1 expression in the NSCLC component had significantly longer overall survival (OS) and recurrence-free survival (RFS) than those with low PD-L1 expression in the NSCLC component (OS: p = 0.001, RFS: p = 0.038). Multivariate analysis revealed that high PD-L1 expression in the NSCLC component was an independent favorable prognostic factor for OS (p = 0.018), whereas high PD-L1 expression in the sarcomatoid component was not. The number of CD8-positive TILs was significantly higher in the high PD-L1 expression group than in the low expression group (NSCLC components: p < 0.001).
High PD-L1 expression in the NSCLC component may be associated with a favorable prognostic value in pulmonary PC.
肺多形性癌（PC）是一种罕见的非小细胞肺癌（NSCLC），其特征为肉瘤样成分和NSCLC成分。本研究旨在明确免疫微环境因素与PC临床病理特征之间的关联。
纳入80例接受了完整手术切除的连续PC患者。我们计算了癌细胞中E-钙黏蛋白、波形蛋白、程序性死亡配体1（PD-L1）和碳酸酐酶IX的免疫组化染色评分，并计数了CD204阳性肿瘤相关巨噬细胞（TAM）以及Foxp3、CD8和CD20阳性肿瘤浸润淋巴细胞（TIL）的数量。我们还研究了这些评分与预后结果之间的关联。
癌细胞中PD-L1的染色评分以及肉瘤样成分中CD204阳性TAM的数量显著高于NSCLC成分中的；肉瘤样成分中E-钙黏蛋白评分显著更低。NSCLC成分中PD-L1高表达的患者总生存期（OS）和无复发生存期（RFS）显著长于NSCLC成分中PD-L1低表达的患者（OS：p = 0.001，RFS：p = 0.038）。多因素分析显示，NSCLC成分中PD-L1高表达是OS的独立有利预后因素（p = 0.018），而肉瘤样成分中PD-L1高表达则不是。高PD-L1表达组中CD8阳性TIL的数量显著高于低表达组（NSCLC成分：p < 0.001）。
NSCLC成分中PD-L1高表达可能与肺PC的良好预后价值相关。
