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智晓玉, 李卫威, 燕翔, 陶海涛, 张智博, 葛祥伟, 汪进良. 探讨非小细胞肺癌术后患者PD-L1表达水平与临床病理特征的关系[J]. 解放军医学院学报, 2021, 42(3): 286-290. DOI: 10.3969/j.issn.2095-5227.2021.03.010
引用本文: 智晓玉, 李卫威, 燕翔, 陶海涛, 张智博, 葛祥伟, 汪进良. 探讨非小细胞肺癌术后患者PD-L1表达水平与临床病理特征的关系[J]. 解放军医学院学报, 2021, 42(3): 286-290. DOI: 10.3969/j.issn.2095-5227.2021.03.010
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ZHI Xiaoyu, LI Weiwei, YAN Xiang, TAO Haitao, ZHANG Zhibo, GE Xiangwei, WANG Jinliang. Correlation of PD-L1 expression and clinicopathological features in surgically resected non-small cell lung cancer[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2021, 42(3): 286-290. DOI: 10.3969/j.issn.2095-5227.2021.03.010
Citation: ZHI Xiaoyu, LI Weiwei, YAN Xiang, TAO Haitao, ZHANG Zhibo, GE Xiangwei, WANG Jinliang. Correlation of PD-L1 expression and clinicopathological features in surgically resected non-small cell lung cancer[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2021, 42(3): 286-290. DOI: 10.3969/j.issn.2095-5227.2021.03.010
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探讨非小细胞肺癌术后患者PD-L1表达水平与临床病理特征的关系

Correlation of PD-L1 expression and clinicopathological features in surgically resected non-small cell lung cancer

    摘要
  • 摘要:
      背景  PD-L1表达水平是非小细胞肺癌(non-small cell lung cancer，NSCLC)患者是否进行PD-1/PD-L1抑制剂治疗的重要生物标志物。然而，PD-L1表达与NSCLC临床病理特征的相关性仍存在争议。
      目的  研究NSCLC术后患者免疫组化(22C3抗体)检测的PD-L1表达水平与患者临床病理特征的相关性。
      方法  收集2019年3 - 8月在解放军总医院第一医学中心确诊并接受手术治疗的NSCLC患者的临床病理资料，分析肿瘤组织标本中PD-L1表达水平与患者临床病理特征的关系。
      结果  178例入组患者平均年龄58.7岁，其中男性82例，女性96例。依据PD-L1表达水平将其分为阳性表达( ≥ 1%)及阴性表达(＜1%)，阳性表达率为51.7%(92/178)。肺鳞癌组PD-L1阳性表达率为77.8%(21/27)，高于腺癌组的47.0%(71/151)(P=0.003)。在肺腺癌组中，多因素分析结果显示有淋巴结转移的患者PD-L1表达水平高于无淋巴结转移患者(OR=3.392，95% CI：1.055 ~ 10.90，P=0.040)；Ki-67表达水平较高患者PD-L1表达水平较高(OR=1.028，95% CI：1.004 ~ 1.054，P=0.024)，二者Spearman相关性分析呈正相关(r=0.363，P＜0.001)。
      结论  肺鳞癌患者PD-L1表达水平高于肺腺癌患者。淋巴结转移或Ki-67表达水平是PD-L1表达水平的影响因素。该研究结果可能为筛选PD-L1表达水平较高的NSCLC患者提供参考依据。

     

    Abstract:
      Background  PD-L1 expression is an important biomarker for patients to choose PD-1/PD-L1 inhibitors treatment. However, the correlation between PD-L1 expression and clinicopathological characteristics of non-small cell lung cancer (NSCLC) is still controversial.
      Objective  To explore the correlation between PD-L1 expression detected by Immunohistochemistry (22C3) and the clinicopathological characteristics in surgically resected NSCLC patients.
      Methods  The medical records of NSCLC patients who were diagnosed and underwent surgery in the First Medical Center of Chinese PLA General Hospital from March to August in 2019 were collected, and the correlation between the PD-L1 expression and clinicopathological characteristics was analyzed.
      Results  A total of 178 patients were enrolled in this study, with 82 males and 96 females, mean age of 58.7 years. PD-L1 expression rate of 1% or greater was defined as PD-L1-positive, and the positive PD-L1 expression rate was 51.7%. Compared with the lung adenocarcinoma, the PD-L1 expression was significantly higher in squamous cell carcinoma (77.8% vs 47.0%, P=0.003). In the patients with lung adenocarcinoma, multivariate analysis indicated that expression of PD-L1 was higher in patients with lymph node metastasis than those without lymph node metastasis (OR=3.392, 95% CI: 1.055 - 10.90, P=0.040), and patients with high Ki-67 index were tended to have higher PD-L1 expression (OR=1.028, 95% CI: 1.004 - 1.054, P=0.024). Moreover, Spearman rank correlation demonstrated that PD-L1 expression was positively correlated with Ki-67 index (r=0.363, P＜0.001).
      Conclusion  PD-L1 expression in lung squamous cell carcinoma is significantly higher than that in adenocarcinoma. Lymph node metastasis and Ki-67 index are the influencing factors of PD-L1 expression in lung adenocarcinoma. The results of our study may be helpful for screening patients with higher PD-L1 expression in NSCLC patients successfully.

     

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