Prognostic Significance of PD-L1 in Patients with Non-Small Cell Lung Cancer: A Large Cohort Study of Surgically Resected Cases
Prognostic Significance of PD-L1 in Patients with Non-Small Cell Lung Cancer: A Large Cohort Study of Surgically Resected Cases
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DOI：
10.1016/j.jtho.2016.04.007
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发表时间：
2016-07-01
影响因子：
20.4
通讯作者：
Kim, Jhingook
中科院分区：
文献类型：
--
作者：
Sun, Jong-Mu;Zhou, Wei;Kim, Jhingook
简介：方法：采用免疫组化方法检测1070例手术切除的非小细胞肺癌（NSCLC）标本中PD-L1的表达，并分析其与NSCLC预后的关系。数据分析采用考克斯比例风险模型调整年龄，性别，吸烟状况，组织学类型，阶段，和性能status.Results：68例（6%）强PD-L1阳性和410（38%）弱PD-L1阳性。在鳞状细胞癌患者以及BIB和IV期患者中观察到PD-L1阳性的患病率显著较高。PD-L1表达可能与较差的总生存期相关，调整后的风险比为1.56（95%置信区间[CI]：1.082.26，p = 0.02）强PD-L1阳性，1.18（95% CI：0.96 - 1.46; p = 0.12），强阳性和弱阳性组合组与PD-L1阴性相比为1.23（95% CI：1.00 - 1.51; p = 0.05）。在调整术后化疗或放疗后，PD-L1表达对预后的负面影响无统计学意义。无进展生存期也观察到类似结果。在I期患者中，PD-L1阳性组的疾病复发率高于PD-L1阴性组（48%对27%，p <0.001），无病生存的校正风险比为2.01（95% CI，1.08 - 3.73; p = 0.03）强PD-L1阳性和1.57（95% CI，1.17 - 2.11; p = 0.003）弱PD-L1阳性与PD-L1阴性相比。肿瘤PD-L1表达可能与NSCLC患者的不良预后相关，尽管考虑术后治疗时其意义减弱。(C)2016年国际肺癌研究协会。爱思唯尔公司出版All rights reserved.
Introduction: The aim of our analysis was to evaluate the prognostic effect of programmed cell death ligand-1 (PD-L1) expression in patients with non-small cell lung cancer (NSCLC).Methods: PD-L1 expression among 1070 surgically resected NSCLC specimens was evaluated by immunohistochemical analysis. Data were analyzed using Cox proportional hazard models adjusting for age, sex, smoking status, histologic type, stage, and performance status.Results: Sixty-eight patients (6%) were strongly PD-L1 positive and 410 (38%) were weakly PD-L1 positive. A significantly higher prevalence of PD-L1 positivity was observed among patients with squamous cell carcinoma and among stage BIB and IV patients. PD-L1 expression may be associated with poorer overall survival, with an adjusted hazard ratio of 1.56 (95% confidence interval [CI]: 1.082.26, p = 0.02) for strong PD-L1 positivity, 1.18 (95% CI: 0.96-1.46; p = 0.12) for weak PD-L1 positivity, and 1.23 (95% CI: 1.00-1.51; p = 0.05) for the combined strongly and weakly positive groups compared with PD-L1 negativity. Negative prognostic effect of PD-L1 expression was not statistically significant after adjustment for postoperative chemotherapy or radiotherapy. Similar results were observed for progression-free survival. Among stage I patients, the disease recurrence rate was higher in the PD-L1-positive versus in the PD-L1-negative group (48% versus 27%, p < 0.001), with an adjusted hazard ratio for disease-free survival of 2.01 (95% CI, 1.08-3.73; p = 0.03) for strong PD-L1 positivity and 1.57 (95% CI, 1.17-2.11; p = 0.003) for weak PD-L1 positivity compared with PD-L1 negativity.Conclusions: Tumor PD-L1 expression may be associated with poor prognosis in patients with NSCLC, although its significance weakens when postoperative therapy is considered. (C) 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.