Sakaguchi Tadashi, Iketani Akemi, Ito Kentaro, Nishii Yoichi, Katsuta Koji, Hataji Osamu
Department of Respiratory Medicine, Matsusaka Municipal Hospital, 1550 Tonomachi, Matsusaka 515-0073, Mie, Japan.
Pathology Department, Matsusaka Municipal Hospital, 1550 Tonomachi, Matsusaka 515-0073, Mie, Japan.
Cancers (Basel). 2025 Jan 25;17(3):398. doi: 10.3390/cancers17030398.
Recent advances in perioperative immunotherapies have led to a new era in the perioperative treatment of resectable, non-small cell lung cancer (NSCLC). Although the choice of neoadjuvant, adjuvant or perioperative immunotherapy remains controversial, few reports have compared programmed death ligand-1 (PD-L1) expression as a biomarker between preoperative biopsy specimens and surgical specimens.
We retrospectively reviewed consecutive patients with NSCLC whose preoperative biopsy specimens and surgical specimens were tested for PD-L1 (22C3) and PD-L1 (SP263), respectively, from June 2022 to February 2024. The three categorical classifications of PD-L1 expression (negative [<1%], low [1-49%], and high [≥50%]) were compared between the two tests.
Of the 33 patients, 13 patients had negative PD-L1 expression, 9 patients had low PD-L1 expression and 11 patients had high PD-L1 expression with preoperative biopsy specimens, while 18 patients had negative PD-L1 expression, 10 patients had low PD-L1 expression and 5 patients had high PD-L1 expression with surgical specimens. The concordance rate for the three categorical classifications of PD-L1 expression between the preoperative biopsy specimens and surgical specimens was 57.6%.
PD-L1 expression may differ between preoperative biopsy specimens and surgical specimens. PD-L1 expression evaluated using small biopsy specimens may be largely influenced by chance due to intra-tumoral heterogeneity.
围手术期免疫治疗的最新进展开启了可切除非小细胞肺癌（NSCLC）围手术期治疗的新时代。尽管新辅助、辅助或围手术期免疫治疗的选择仍存在争议，但很少有报告比较术前活检标本和手术标本中程序性死亡配体-1（PD-L1）表达作为生物标志物的情况。
我们回顾性分析了2022年6月至2024年2月期间连续的NSCLC患者，其术前活检标本和手术标本分别检测了PD-L1（22C3）和PD-L1（SP263）。比较了两种检测中PD-L1表达的三种分类（阴性[<1%]、低表达[1-49%]和高表达[≥50%]）。
33例患者中，术前活检标本显示13例患者PD-L1表达阴性，9例患者PD-L1低表达，11例患者PD-L1高表达；手术标本显示18例患者PD-L1表达阴性，10例患者PD-L1低表达，5例患者PD-L1高表达。术前活检标本和手术标本中PD-L1表达的三种分类的一致率为57.6%。
术前活检标本和手术标本中的PD-L1表达可能存在差异。由于肿瘤内异质性，使用小活检标本评估的PD-L1表达可能在很大程度上受偶然性影响。
