Onodera Ken, Notsuda Hirotsugu, Kumata Sakiko, Watanabe Tatsuaki, Watanabe Yui, Suzuki Takaya, Hirama Takashi, Oishi Hisashi, Okada Yoshinori
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Seiryomachi 4-1, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Surg Today. 2025 Jun 4. doi: 10.1007/s00595-025-03070-6.
The expression of PD-L1 is linked to lung cancer severity; however, its prognostic value after resection is unclear. In this study, we investigated its role in resected lung cancers.
We analyzed 658 patients with stage pIA-IIIA NSCLC who underwent complete resection. We assessed the PD-L1 expression by stage and its link to cancer severity, focusing further on its prognostic impact in resected stage I cell lung cancer.
The high expression of PD-L1 increased with disease progression (13.0% in IA to 36.2% in III). In stage I non-small cell lung cancer, elevated PD-L1 expression levels were more common in patients with serum CEA levels ≥ 5 (26.0%), SUVmax ≥ 5 (26.7%), and squamous cell carcinoma (41.5%). PD-L1-negative patients showed a better prognosis than PD-L1-positive patients, even with the use of immune checkpoint inhibitors following relapse (5-year OS: 94.3% vs. 83.2%, p < 0.01).
The expression of PD-L1 in lung cancer appears to be associated with oncological severity and may influence the prognosis of early-stage disease. Additionally, in early-stage lung cancer, immune checkpoint inhibitors may not fully compensate for the negative prognostic impact of the high expression of PD-L1.
PD-L1的表达与肺癌严重程度相关；然而，其在切除术后的预后价值尚不清楚。在本研究中，我们调查了其在切除的肺癌中的作用。
我们分析了658例接受根治性切除的pIA-IIIA期非小细胞肺癌患者。我们按分期评估了PD-L1表达及其与癌症严重程度的关联，并进一步关注其对切除的I期肺癌预后的影响。
PD-L1的高表达随疾病进展而增加（IA期为13.0%，III期为36.2%）。在I期非小细胞肺癌中，血清CEA水平≥5（26.0%）、SUVmax≥5（26.7%）和鳞状细胞癌（41.5%）的患者中，PD-L1表达升高更为常见。PD-L1阴性患者的预后优于PD-L1阳性患者，即使在复发后使用免疫检查点抑制剂也是如此（5年总生存率：94.3%对83.2%，p<0.01）。
肺癌中PD-L1的表达似乎与肿瘤学严重程度相关，并可能影响早期疾病的预后。此外，在早期肺癌中，免疫检查点抑制剂可能无法完全弥补PD-L1高表达的负面预后影响。
