Sunpaweravong Patrapim, Thongwatchara Patcharaporn, Chotipanvithayakul Rassamee, Sangkhathat Surasak, Thongsuksai Paramee
Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Department of Biomedical Science, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Clin Med Insights Oncol. 2022 Apr 22;16:11795549221092747. doi: 10.1177/11795549221092747. eCollection 2022.
Non-small cell lung cancer (NSCLC) remains a leading cause of cancer death worldwide, for which better knowledge in molecular prognostic factors is needed to improve clinical outcome. This study aimed to investigate the clinical significance of c-Myc, ALK, ROS1, BRAF, and PD-L1 in NSCLC patients.
Formalin-fixed paraffin-embedded tissue specimens were obtained from 124 NSCLC patients. Of these, 66 matched specimens of normal respiratory epithelial and tumor tissue from patients with stages I-III, who underwent surgical resection, and 58 NSCLC specimens from stage IV patients were recruited into this analysis. Immunohistochemistry staining along with semiquantitative criteria were used to evaluate the expression of the interested proteins.
Of the 66 patients with stages I-III, positive expression of c-Myc was detected in 12 specimens (18.2%) of NSCLC tissue, whereas none of the normal respiratory epithelial tissue was found to have c-Myc expression ( < .001). Of the 66 NSCLC patients, 28 (43.8%) had PD-L1-positive staining on 1%-49% tumor cells and 7 (10.9%) patients expressed PD-L1 in ⩾50% tumor cells. One (2.3%) adenocarcinoma patient was found to have ROS1 rearrangement. Patients with no expression of c-Myc and PD-L1 (co-negative expression) tended to have a better prognosis than other subgroups.
NSCLC tissue significantly expressed more c-Myc and PD-L1, compared with the matched normal respiratory epithelium, emphasizing the important role of these key drivers in tumorigenesis. Therapeutic approach to precisely inhibit the targetable molecular pathways should be considered on an individual patient basis to improve survival outcome.
非小细胞肺癌（NSCLC）仍是全球癌症死亡的主要原因，需要更好地了解分子预后因素以改善临床结局。本研究旨在探讨c-Myc、ALK、ROS1、BRAF和PD-L1在NSCLC患者中的临床意义。
从124例NSCLC患者中获取福尔马林固定石蜡包埋的组织标本。其中，66例来自接受手术切除的I-III期患者的正常呼吸上皮和肿瘤组织的匹配标本，以及58例IV期患者的NSCLC标本被纳入本分析。采用免疫组织化学染色及半定量标准评估相关蛋白的表达。
在66例I-III期患者中，12例（18.2%）NSCLC组织标本检测到c-Myc阳性表达，而正常呼吸上皮组织均未发现c-Myc表达（P<0.001）。在66例NSCLC患者中，28例（43.8%）肿瘤细胞1%-49%有PD-L1阳性染色，7例（10.9%）患者肿瘤细胞≥50%表达PD-L1。1例（2.3%）腺癌患者发现有ROS1重排。c-Myc和PD-L1无表达（共阴性表达）的患者预后往往优于其他亚组。
与匹配的正常呼吸上皮相比，NSCLC组织中c-Myc和PD-L1表达明显更高，强调了这些关键驱动因素在肿瘤发生中的重要作用。应根据个体患者情况考虑精确抑制可靶向分子途径的治疗方法，以改善生存结局。
