Gu Dongmei, Hu Lin, Huang Shan, Guo Lingchuan
Department of Pathology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection & School for Radiological and Interdisciplinary Sciences, Soochow University, Suzhou, Jiangsu, China.
Cytojournal. 2024 Dec 20;21:70. doi: 10.25259/Cytojournal_59_2024. eCollection 2024.
Programmed death ligand-1 (PD-L1) is involved in tumor immune escape and is an important target molecule for the immunotherapy of non-small-cell lung cancer (NSCLC). The expression of PD-L1 affects NSCLC invasion, metastasis, and patient survival. This study aims to explore the levels of PD-L1, as identified by the 22C3 antibody, in the malignant pleural effusion of patients suffering from advanced NSCLC, and to determine its clinical implications.
A two-step immunohistochemical EnVision assay was used to evaluate the expression of PD-L1 by the 22C3 antibody in 149 malignant pleural fluid cell wax clots of NSCLC. The relationship between PDL1 expression and clinicopathological characteristics, anaplastic lymphoma kinase (ALK) expression, epidermal growth factor receptor (EGFR) mutation, and overall survival (OS) time of patients with NSCLC was analyzed.
Positive expression of PD-L1 in malignant pleural fluid of NSCLC was observed as follows: Positive (<1%: 11.4%), positive (1-49%: 19.5%), and positive (≥50%: 11.4%), with a total positive rate of 42.3%. There was a significant association between PD-L1-positive expression and factors such as tumor differentiation, lymph node metastasis, and metastasis to other organs ( < 0.05). Furthermore, PD-L1 expression showed a positive correlation with ALK expression (rs = 11.49, < 0.05) but did not correlate with EGFR mutations (rs = 0.004, > 0.05). Significant differences in median OS were observed between patients exhibiting positive PD-L1 expression and those without, according to survival follow-up data ( < 0.05).
Immunohistochemical detection of PD-L1 expression in malignant pleural fluid of advanced NSCLC provides a basis for clinical tumor immunotherapy. Immunohistochemical detection of PD-L1 expression in malignant pleural fluid of advanced NSCLC is minimally invasive, simple, and fast, particularly for metastatic NSCLC where malignant pleural fluid is the first symptom, offering significant clinical application value.
程序性死亡配体1（PD-L1）参与肿瘤免疫逃逸，是非小细胞肺癌（NSCLC）免疫治疗的重要靶分子。PD-L1的表达影响NSCLC的侵袭、转移及患者生存。本研究旨在探讨经22C3抗体鉴定的晚期NSCLC患者恶性胸腔积液中PD-L1的水平，并确定其临床意义。
采用两步免疫组化EnVision法评估22C3抗体在149例NSCLC恶性胸腔积液细胞蜡块中PD-L1的表达。分析PD-L1表达与NSCLC患者临床病理特征、间变性淋巴瘤激酶（ALK）表达、表皮生长因子受体（EGFR）突变及总生存（OS）时间的关系。
NSCLC恶性胸腔积液中PD-L1的阳性表达情况如下：阳性（<1%：11.4%）、阳性（1-49%：19.5%）和阳性（≥50%：11.4%），总阳性率为42.3%。PD-L1阳性表达与肿瘤分化、淋巴结转移及其他器官转移等因素之间存在显著关联（<0.05）。此外，PD-L1表达与ALK表达呈正相关（rs = 11.49，<0.05），但与EGFR突变无相关性（rs = 0.004，>0.05）。根据生存随访数据，PD-L1表达阳性和阴性的患者中位OS存在显著差异（<0.05）。
晚期NSCLC恶性胸腔积液中PD-L1表达的免疫组化检测为临床肿瘤免疫治疗提供了依据。晚期NSCLC恶性胸腔积液中PD-L1表达的免疫组化检测具有微创、简单、快速的特点，尤其对于以恶性胸腔积液为首发症状的转移性NSCLC具有重要临床应用价值。
