PD-L1 is a Prognostic Biomarker in Resected NSCLC Patients with Moderate/high Smoking History and Elevated Serum SCCA Level.
PD-L1 is a Prognostic Biomarker in Resected NSCLC Patients with Moderate/high Smoking History and Elevated Serum SCCA Level.
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PD-L1 是具有中度/高度吸烟史且血清 SCCA 水平升高的已切除 NSCLC 患者的预后生物标志物
DOI：
10.7150/jca.21118
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发表时间：
2017
影响因子：
3.9
通讯作者：
Jiang R
中科院分区：
文献类型：
--
作者：
Cao L;Wang X;Li S;Zhi Q;Wang Y;Wang L;Li K;Jiang R
程序性细胞死亡-1（PD-1）靶向免疫治疗已成为晚期非小细胞肺癌（NSCLC）患者的一种有前途的治疗模式。NSCLC检查点抑制治疗的临床应答与程序性死亡-1配体1（PD-L1）表达相关。然而，PD-L1和PD-L2的表达与NSCLC的临床病理特征和患者结局之间的关系尚不清楚。我们回顾性分析了2009年至2012年期间接受完全切除术的364例患者（158例鳞状细胞癌和206例腺癌）。免疫组化法检测PD-L1和PD-L2的表达。分析PD-L1/PD-L2表达与临床病理特征和生存参数的相关性，并确定预后因素。PD-L1表达与中度/重度吸烟史和血清鳞状细胞癌抗原（SCCA）水平显著相关。多变量分析显示，在50%临界值时，PD-L1高表达患者的无病生存期（DFS，HR 1.411，P = 0.025）和总生存期（OS，HR 1.659，P = 0.004）显著短于PD-L1低表达患者。PD-L2表达与患者术后生存率之间无显著相关性。进一步分层分析显示，在有中/重度吸烟史、血清SCCA水平升高和鳞状细胞癌的患者中，PD-L1表达与DFS和OS显著缩短相关。因此，PD-L1表达与NSCLC患者的中/重度吸烟史和血清SCCA水平升高相关，并且是生存的独立不良预测因子。
Programmed cell death-1 (PD-1) -targeted immunotherapy has become a promising treatment paradigm for patients with advanced non-small cell lung cancer (NSCLC). Clinical responses to checkpoint inhibition therapy in NSCLC have been associated with programmed death-1 ligand 1 (PD-L1) expression. However, the association between the expression of PD-L1 and PD-L2 and the clinicopathological features and patient outcomes in NSCLC remain unclear. We retrospectively analyzed 364 patients (158 squamous cell carcinoma and 206 adenocarcinoma) who underwent complete resection between 2009 and 2012. Expression of PD-L1 and PD-L2 was determined by immunohistochemistry. Correlations between PD-L1/PD-L2 expression and the clinicopathological features and survival parameters were analyzed and prognostic factors were identified. PD-L1 expression was significantly associated with moderate/heavy smoking history and serum squamous cell carcinoma antigen (SCCA) levels. Multivariate analysis showed patients with high PD-L1 expression had significantly shorter disease free survival (DFS, HR 1.411, P = 0.025) and overall survival (OS, HR 1.659, P = 0.004) than those with low PD-L1 expression at a 50% cutoff value. No significant association was found between PD-L2 expression and patient postoperative survival. Further stratification analysis revealed that in patients with moderate/heavy smoking history, elevated serum SCCA level, and squamous cell carcinoma, PD-L1 expression was associated with significantly shorter DFS and OS. Therefore, PD-L1 expression was correlated with moderate/heavy smoking history and elevated serum SCCA level in NSCLC patients, and was an independently poor predictor of survival.
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