Departments of Chest Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Thorac Cancer. 2021 Dec;12(23):3169-3176. doi: 10.1111/1759-7714.14177. Epub 2021 Oct 15.
The current study aimed to evaluate the significance of clinicopathological factors, particularly the immunohistochemistry of programed cell death ligand-1 (PD-L1), in eight cases each of pulmonary sarcomatoid carcinoma (PSC) and malignant pleural mesothelioma (MPM) at our hospital.
From January 2004 to December 2020, a total of 16 consecutive patients (eight with PSC and eight with MPM diagnosed via surgical resection or biopsy) were included in this study. After retrospectively reviewing the patient characteristics, the associations between PD-L1 status and age, sex, stage, histological type, and prognosis were investigated.
PD-L1-positive staining was observed in four (50%) PSC cases and one (12.5%) MPM case. Among the four PD-L1-positive PSC cases, two showed high PD-L1 expression in the vimentin-positive sarcomatoid compartment. Moreover, among those with PSC, two survived for about 10 years, whereas the others died within 5 years. No clear correlation was found between PD-L1 expression and prognosis. Among the patients with MPM, four survived for more than 2 years, with the longest being 9 years. Among MPM cases who received nivolumab, one patient with positive PD-L1 staining in the sarcomatoid survived, whereas the other with negative PD-L1 staining did not.
The present study showed that sarcomatoid carcinoma had a higher PD-L1 expression compared to non-small-cell lung cancer and that both PSC and MPM tended to exhibit PD-L1 positivity in the sarcomatoid compartment. Moreover, while immune checkpoint inhibitors may somewhat prolong the prognosis of both tumors, further studies with a larger cohort are necessary to confirm our results.
本研究旨在评估临床病理因素的意义，特别是程序性细胞死亡配体-1（PD-L1）的免疫组化，在我院 8 例肺肉瘤样癌（PSC）和 8 例恶性胸膜间皮瘤（MPM）中。
2004 年 1 月至 2020 年 12 月，共纳入 16 例连续患者（8 例经手术切除或活检诊断为 PSC，8 例为 MPM）。回顾性分析患者特征后，研究 PD-L1 状态与年龄、性别、分期、组织学类型和预后的关系。
在 8 例 PSC 中，有 4 例（50%）和 1 例（12.5%）MPM 为 PD-L1 阳性染色。在 4 例 PD-L1 阳性 PSC 中，2 例在波形蛋白阳性的肉瘤样区有高 PD-L1 表达。此外，在 PSC 患者中，有 2 例存活了约 10 年，而其他患者在 5 年内死亡。PD-L1 表达与预后无明显相关性。在 MPM 患者中，有 4 例存活超过 2 年，最长者为 9 年。在接受纳武单抗治疗的 MPM 患者中，1 例 PD-L1 染色阳性的肉瘤样患者存活，而另 1 例 PD-L1 染色阴性的患者未存活。
本研究表明，肉瘤样癌的 PD-L1 表达高于非小细胞肺癌，PSC 和 MPM 倾向于在肉瘤样区表达 PD-L1。此外，尽管免疫检查点抑制剂可能在一定程度上延长两种肿瘤的预后，但需要进一步的大样本队列研究来证实我们的结果。
