Du Min, Cai Yumeng, Pang Yanrui, Ji Yuan
Pathology Department, Huadong Hospital, Fudan University, Shanghai, 200040, China.
Pathology Department, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
ILIVER. 2022 Sep 7;1(3):187-193. doi: 10.1016/j.iliver.2022.08.005. eCollection 2022 Sep.
Programmed cell death ligand 1 (PD-L1) expression plays an important role in selecting patients with hepatocellular carcinoma who will benefit from anti-programmed cell death 1 (PD-1)/PD-L1 monotherapy and directing those with lower levels to alternative treatments.
In total, 156 hepatocellular carcinoma tumors were stained with three PD-L1 immunohistochemistry assays (SP142, 28-8, and E1L3N). Two junior pathologists and one senior pathologist evaluated the pathological slides and recorded the percentages of tumor and immune cells stained at any intensity.
Analytical comparisons demonstrated that the anti-PD-L1 assay SP142 is a significantly stronger reagent that stains a higher percent of both tumor and immune cells, while 28-8 and E1L3N behave similarly to each other. The correlation coefficients of the three assays ranged from 0.77 to 0.92 for tumor cells and from 0.66 to 0.75 for immune cells. Next, 1% and 5% tumor cell staining cutoffs were designated using various combinations of assays and cutoffs. Across all three reagents, 14 samples showed concordance above the 5% threshold, eight showed concordance within the range of 1% to 5% interval, and 93 showed concordance below the 1% threshold. The remaining 41 samples showed a combination of discordant results across all three reagents. High PD-L1 expression in tumor and immune cells tended to not be recurrent.
The anti-PD-L1 assays 28-8 and E1L3N were closely aligned with regard to staining tumor and immune cells, whereas SP142 showed higher percentages of staining for both cell types. All three assays indicated greater variability in immune cell staining than in tumor cells.
程序性细胞死亡配体1（PD-L1）表达在选择将从抗程序性细胞死亡蛋白1（PD-1）/PD-L1单药治疗中获益的肝细胞癌患者以及指导低表达患者选择其他治疗方法方面发挥着重要作用。
总共156个肝细胞癌肿瘤用三种PD-L1免疫组织化学检测方法（SP142、28-8和E1L3N）进行染色。两名初级病理学家和一名高级病理学家评估病理切片，并记录任何强度染色的肿瘤细胞和免疫细胞百分比。
分析比较表明，抗PD-L1检测方法SP142是一种显著更强的试剂，能使更高比例的肿瘤细胞和免疫细胞染色，而28-8和E1L3N的表现彼此相似。三种检测方法对肿瘤细胞的相关系数范围为0.77至0.92，对免疫细胞的相关系数范围为0.66至0.75。接下来，使用检测方法和临界值的各种组合指定1%和5%的肿瘤细胞染色临界值。在所有三种试剂中，14个样本在5%阈值以上显示一致性，8个样本在1%至5%区间内显示一致性，93个样本在1%阈值以下显示一致性。其余41个样本在所有三种试剂中显示出不一致结果的组合。肿瘤细胞和免疫细胞中高PD-L1表达往往不会复发。
抗PD-L1检测方法28-8和E1L3N在肿瘤细胞和免疫细胞染色方面密切相关，而SP142对两种细胞类型的染色百分比更高。所有三种检测方法均表明免疫细胞染色比肿瘤细胞染色的变异性更大。
