Department of Radiology, Huadong Hospital, Fudan University, Shanghai, 200040, China.
BMC Cancer. 2024 May 25;24(1):642. doi: 10.1186/s12885-024-12400-9.
PD-L1 was an important biomarker in lung adenocarcinoma. The study was to confirm the most important factor affecting the expression of PD-L1 remains undetermined.
The clinical records of 1045 lung adenocarcinoma patients were retrospectively reviewed. The High-Resolution Computed Tomography (HRCT) scanning images of all the participants were analyzed, and based on the CT characteristics, the adenocarcinomas were categorized according to CT textures. Furthermore, PD-L1 expression and Ki67 index were detected by immunohistochemistry. All patients underwent EGFR mutation detection.
Multivariate logistic regression analysis revealed that smoking (OR: 1.73, 95% CI: 1.04-2.89, p = 0.004), EGFR wild (OR: 1.52, 95% CI: 1.11-2.07, p = 0.009), micropapillary subtypes (OR: 2.05, 95% CI: 1.46-2.89, p < 0.0001), and high expression of Ki67 (OR: 2.02, 95% CI: 1.44-2.82, p < 0.0001) were independent factors which influence PD-L1 expression. In univariate analysis, tumor size > 3 cm and CT textures of pSD showed a correlation with high expression of PD-L1. Further analysis revealed that smoking, micropapillary subtype, and EGFR wild type were also associated with high Ki67 expression. Moreover, high Ki67 expression was observed more frequently in tumors of size > 3 cm than in tumors with ≤ 3 cm size as well as in CT texture of pSD than lesions with GGO components. In addition, multivariate logistic regression analysis revealed that only lesions with micropapillary components correlated with pSD (OR: 3.96, 95% CI: 2.52-5.37, p < 0.0001).
This study revealed that in lung adenocarcinoma high Ki67 expression significantly influenced PD-L1 expression, an important biomarker for immune checkpoint treatment.
PD-L1 是肺腺癌的一个重要生物标志物。本研究旨在确认影响 PD-L1 表达的最重要因素仍未确定。
回顾性分析 1045 例肺腺癌患者的临床资料。对所有患者的高分辨率 CT（HRCT）扫描图像进行分析，并根据 CT 特征，按照 CT 纹理将腺癌分为不同类型。此外，采用免疫组织化学法检测 PD-L1 表达和 Ki67 指数。所有患者均进行 EGFR 突变检测。
多因素 logistic 回归分析显示，吸烟（OR：1.73，95%CI：1.04-2.89，p=0.004）、EGFR 野生型（OR：1.52，95%CI：1.11-2.07，p=0.009）、微乳头亚型（OR：2.05，95%CI：1.46-2.89，p<0.0001）和 Ki67 高表达（OR：2.02，95%CI：1.44-2.82，p<0.0001）是影响 PD-L1 表达的独立因素。单因素分析显示，肿瘤直径>3cm 和 CT 纹理 pSD 与 PD-L1 高表达相关。进一步分析显示，吸烟、微乳头亚型和 EGFR 野生型也与 Ki67 高表达相关。此外，Ki67 高表达在肿瘤直径>3cm 时比肿瘤直径≤3cm 时更为常见，在 CT 纹理 pSD 时比 GGO 成分时更为常见。此外，多因素 logistic 回归分析显示，只有微乳头成分与 pSD 相关（OR：3.96，95%CI：2.52-5.37，p<0.0001）。
本研究表明，在肺腺癌中，高 Ki67 表达显著影响 PD-L1 表达，PD-L1 是免疫检查点治疗的一个重要生物标志物。
