Can PD-L1 expression evaluated by biopsy sample accurately reflect its expression in the whole tumour in gastric cancer?
Can PD-L1 expression evaluated by biopsy sample accurately reflect its expression in the whole tumour in gastric cancer?
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DOI：
10.1038/s41416-019-0515-5
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发表时间：
2019-07
影响因子：
8.8
通讯作者：
Kohei Yamashita;M. Iwatsuki;K. Harada;Y. Koga;Y. Kiyozumi;K. Eto;Y. Hiyoshi;T. Ishimoto;S. Iwagami;Y. Baba;Y. Miyamoto;N. Yoshida;Y. Komohara;J. Ajani;H. Baba
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文献类型：
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作者：
Kohei Yamashita;M. Iwatsuki;K. Harada;Y. Koga;Y. Kiyozumi;K. Eto;Y. Hiyoshi;T. Ishimoto;S. Iwagami;Y. Baba;Y. Miyamoto;N. Yoshida;Y. Komohara;J. Ajani;H. Baba
程序性死亡配体 1 (PD-L1) 表达作为程序性细胞死亡 1 (PD-1) 抑制剂在胃癌 (GC) 中疗效的预测生物标志物仍然存在争议。我们假设，相互矛盾的结果可能是由于使用活检样本对 PD-L1 表达的评估不准确造成的。共有 191 名接受根治性切除的 GC 患者入组。根据活检数量比较活检组织和配对切除样本中免疫组织化学染色的 PD-L1 表达。通过活检和切除样本确定的 PD-L1 阳性患者数量分别为 89 例（46.6%）和 135 例（70.1%）。符合率为64.4%(κ = 0.31)。与多次活检相比，单次活检的符合率较低。我们的研究表明，单次活检不能完全反映GC中整个肿瘤中PD-L1的表达。建议进行多次活检以准确诊断 GC 中的 PD-L1 表达。
Programmed death ligand 1 (PD-L1) expression as a predictive biomarker for programmed cell death 1 (PD-1) inhibitor efficacy in gastric cancer (GC) remains controversial. We hypothesised that the conflicting results may be due to the inaccurate assessment of PD-L1 expression using biopsy samples. A total of 191 patients with GC who received radical resection were enrolled. PD-L1 expressions in biopsy and paired resected samples by immunohistochemistry staining were compared according to the number of biopsies. The numbers of PD-L1-positive patients determined by biopsy and resected samples were 89 (46.6%) and 135 (70.1%), respectively. The accordance rate was 64.4% (κ = 0.31). Single biopsy showed a lower accordance rate compared with multiple biopsies. Our study revealed that single biopsy cannot fully reflect PD-L1 expression in the whole tumour in GC. Multiple biopsies are recommended for accurate diagnosis of PD-L1 expression in GC.