Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-ku, Yokohama, Kanagawa, 221-0855, Japan.
BMC Cancer. 2022 Sep 13;22(1):977. doi: 10.1186/s12885-022-10065-w.
Granulocyte colony-stimulating factor (G-CSF)-producing lung cancer induces severe inflammation and a high white blood cell (WBC) count and is associated with poor prognosis. A recent case of G-CSF-producing lung adenocarcinoma showed high expression of programmed cell death ligand 1 (PD-L1) and was treated with pembrolizumab as first-line therapy, which was extremely effective. We hypothesized that G-CSF-producing lung cancers are associated with high PD-L1 expression.
This retrospective study included patients diagnosed with lung cancer at Yokohama Municipal Citizen's Hospital (Kanagawa, Japan) between 2009 and 2019. The PD-L1 status of 13 patients with high plasma G-CSF levels (≥40 pg/mL) was assessed by conducting immunohistochemical analysis of tissue samples.
Of the total patients, 11 were men and 2 were women, with a median age of 74 years (70-85 years). Four, five, and three patients had adenocarcinoma, squamous cell carcinoma, and others, respectively. The median G-CSF level and WBC count were 85.5 pg/mL (range, 40.8-484 pg/mL) and 15,550/μL (range, 6,190-56,800/μL), respectively. The PD-L1 tumor proportion scores (TPSs) were ≥50%, 1%-49%, and <1% in 9, 1, and 3 patients, respectively. The median overall survival time was 7.3 months. Pembrolizumab was administered in six patients as first-line treatment, with two patients showing partial response, one patient with stable disease, and three patients with progressive disease. All six patients had a PD-L1 TPS of ≥50%.
G-CSF-producing lung cancers may be associated with increased PD-L1 expression. Although immune checkpoint inhibitors are an important treatment option for G-CSF-producing tumors, their effects are limited.
产生粒细胞集落刺激因子（G-CSF）的肺癌可引发严重炎症和白细胞计数升高，并与不良预后相关。最近一例产生 G-CSF 的肺腺癌病例表现出高水平的程序性细胞死亡配体 1（PD-L1）表达，并用帕博利珠单抗作为一线治疗，效果非常显著。我们假设产生 G-CSF 的肺癌与高水平的 PD-L1 表达有关。
本回顾性研究纳入了 2009 年至 2019 年在横滨市市民医院（日本神奈川）诊断为肺癌的患者。通过对组织样本进行免疫组织化学分析，评估了 13 例高血浆 G-CSF 水平（≥40pg/mL）患者的 PD-L1 状态。
在所有患者中，男性 11 例，女性 2 例，中位年龄为 74 岁（70-85 岁）。4 例、5 例和 3 例患者分别患有腺癌、鳞状细胞癌和其他类型的肺癌。中位 G-CSF 水平和白细胞计数分别为 85.5pg/mL（范围，40.8-484pg/mL）和 15550/μL（范围，6190-56800/μL）。9 例、1 例和 3 例患者的 PD-L1 肿瘤比例评分（TPS）分别≥50%、1%-49%和<1%。中位总生存期为 7.3 个月。6 例患者接受了帕博利珠单抗作为一线治疗，其中 2 例患者部分缓解，1 例患者病情稳定，3 例患者病情进展。所有 6 例患者的 PD-L1 TPS 均≥50%。
产生 G-CSF 的肺癌可能与 PD-L1 表达增加有关。虽然免疫检查点抑制剂是产生 G-CSF 肿瘤的重要治疗选择，但它们的效果有限。
