IMMUNOHISTOCHEMICAL EXPRESSION OF PD-L1 IN NON-SMALL CELL LUNG CARCINOMA

Authors

  • Muhammad Umair Khan Armed Institute of Pathology, NUMS, Rawalpindi-Pakistan
  • Hafeez ud Din Armed Institute of Pathology, NUMS, Rawalpindi-Pakistan
  • Wajahat Ahmed Khan Armed Institute of Pathology, NUMS, Rawalpindi-Pakistan

Keywords:

Non-small cell lung carcinoma (NSCLC); Programmed death 1; Programmed death ligand 1

Abstract

Background: Lung cancer is a leading cause of death related to cancer worldwide, surpassing the number of deaths caused by breast, colon and prostate cancers. Objective of the study was to determine the frequency immunohistochemical expression of PD-L1 in non-small cell lung carcinoma (NSCLC). It was a descriptive cross-sectional study, carried out at the Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from January 2020 to July 2021. Methods: We inducted total of 145 diagnosed cases of NSCLC irrespective of age, gender, histological grade and stage of carcinoma. Immunohistochemical staining of PD-L1 was done using Leica kit. Patients with no expression for PD-L1 were considered negative, whereas immunohistochemical expression of ≥1% is considered positive. PD-L1 statuses of all patients was determined. The data was analyzed by using SPSS version 25. Results: In our study age ranges from 31 to 85 years with mean age of 64.20±10.90 years. Out of the 145 patients, 126 (86.90%) were male and 19 (13.10%) were females. 108 (74.50%) were squamous cell carcinoma and 37 (25.50%) were adenocarcinoma. Most of them were histological grade II, 88 (60.70%), followed by grade I in 26 (17.9%). Immunohistochemical expression of PD-Ll in NSCLC was found in 35 (24.13%) patients. Of all the positive cases, PD-L1 expression was slightly higher in adenocarcinoma 27.02% as compared to squamous cell carcinoma 23.14%. Conclusion: PD-L1 expression is associated with increased aggressiveness, enhanced tumor progression and shorter survival in patients of NSCLC. This study concluded that frequency of positive immunohistochemical expression of PD-L1 in NSCLC is though low, yet significant in adenocarcinoma as compared to squamous cell carcinoma.

References

Cruz CSD, Tanoue LT, Matthay RA. Lung cancer: epidemiology, etiology, and prevention. Clin Chest Med 2011;32(4):605–44.

Glatzel-Plucinska N, Piotrowska A, Grzegrzolka J, Olbromski M, Rzechonek A, Dziegiel P, et al. SATB1 level correlates with Ki-67 expression and is a positive prognostic factor in non-small cell lung carcinoma. Anticancer Res 2018;38(2):723–36.

Kanitkar AA, Schwartz AG, George J, Soubani AO. Causes of death in long-term survivors of non-small cell lung cancer: A regional Surveillance, Epidemiology, and End Results study. Ann Thorac Med 2018;13(2):76–81.

Konishi J, Yamazaki K, Azuma M, Kinoshita I, Dosaka-Akita H, Nishimura M. B7-H1 expression on non-small cell lung cancer cells and its relationship with tumor-infiltrating lymphocytes and their PD-1 expression. Clin Cancer Res 2004;10(15):5094–100.

Sheppard KA, Fitz LJ, Lee JM, Benander C, George JA, Wooters J, et al. PD-1 inhibits T-cell receptor induced phosphorylation of the ZAP70/CD3ζ signalosome and downstream signaling to PKCθ. FEBS Lett 2004;574(1-3):37–41.

Parra ER, Villalobos P, Mino B, Rodriguez-Canales J. Comparison of different antibody clones for immunohistochemistry detection of programmed cell death ligand 1 (PD-L1) on non–small cell lung carcinoma. Appl Immunohistochem Mol Morphol 2018;26(2):83–93.

Pardoll DM. The blockade of immune checkpoints in cancer immunotherapy. Nat Rev Cancer 2012;12(4):252–64.

Ribas A, Tumeh PC. The future of cancer therapy: selecting patients likely to respond to PD1/L1 blockade. Clin Cancer Res 2014;20(19):4982–4.

Mery CM, Pappas AN, Bueno R, Colson YL, Linden P, Sugarbaker DJ, et al. Similar long-term survival of elderly patients with non-small cell lung cancer treated with lobectomy or wedge resection within the surveillance, epidemiology, and end results database. Chest 2005;128(1):237–45.

Ribas A, Hu-Lieskovan S. What does PD-L1 positive or negative mean? J Exp Med 2016;213(13):2835–40.

Ghosh C, Luong G, Sun Y. A snapshot of the PD-1/PD-L1 pathway. J Cancer 2021;12(9):2735–46.

Chen YY, Wang LB, Zhu HL, Li XY, Zhu YP, Yin YL, et al. Relationship between programmed death-ligand 1 and clinicopathological characteristics in non-small cell lung cancer patients. Chin Med Sci J 2013;28(3):147–51.

Milovanovic IS, Stjepanovic M, Mitrovic D. Distribution patterns of the metastases of the lung carcinoma in relation to histological type of the primary tumor: an autopsy study. Ann Thorac Med 2017;12(3):191–8.

Chang YL, Yang CY, Huang YL, Wu CT, Yang PC. High PD-L1 expression is associated with stage IV disease and poorer overall survival in 186 cases of small cell lung cancers. Oncotarget 2017;8(11):18021–30.

Devesa SS, Bray F, Vizcaino AP, Parkin DM. International lung cancer trends by histologic type: male: female differences diminishing and adenocarcinoma rates rising. Int J Cancer 2005;117(2):294–9.

Ma J, Chi D, Wang Y, Yan Y, Zhao S, Liu H, et al. Prognostic value of PD-L1 expression in resected lung adenocarcinoma and potential molecular mechanisms. J Cancer 2018;9(19):3489–99.

Lin SY, Yang CY, Liao BC, Ho CC, Liao WY, Chen KY, et al. Tumor PD-L1 expression and clinical outcomes in advanced-stage non-small cell lung cancer patients treated with nivolumab or pembrolizumab: real-world data in Taiwan. J Cancer 2018;9(10):1813–20.

Igarashi T, Teramoto K, Ishida M, Hanaoka J, Daigo Y. Scoring of PD-L1 expression intensity on pulmonary adenocarcinomas and the correlations with clinicopathological factors. ESMO Open 2016;1(4):e000083.

Zhang M, Li G, Wang Y, Wang Y, Zhao S, Haihong P, et al. PD-L1 expression in lung cancer and its correlation with driver mutations: a meta-analysis. Sci Rep 2017;7(1):10255.

Miyazawa T, Marushima H, Saji H, Kojima K, Hoshikawa M, Takagi M, et al. PD-L1 expression in non-small-cell lung cancer including various adenocarcinoma subtypes. Ann Thorac Cardiovasc Surg 2019;25(1):1–9.

Cooper WA, Tran T, Vilain RE, Madore J, Selinger CI, Kohonen-Corish M, et al. PD-L1 expression is a favorable prognostic factor in early stage non-small cell carcinoma. Lung Cancer 2015;89(2):181–8.

Scheel AH, Ansén S, Schultheis AM, Scheffler M, Fischer RN, Michels S, et al. PD-L1 expression in non-small cell lung cancer: correlations with genetic alterations. Oncoimmunology 2016;5(5):e1131379.

Lin G, Fan X, Zhu W, Huang C, Zhuang W, Xu H, et al. Prognostic significance of PD-L1 expression and tumor infiltrating lymphocyte in surgically resectable non-small cell lung cancer. Oncotarget 2017;8(48):83986–94.

Remmele W, Stegner H. Recommendation for uniform definition of an immunoreactive score (IRS) for immunohistochemical estrogen receptor detection (ER-ICA) in breast cancer tissue. Pathologe 1987;8(3):138–40.

Takada K, Okamoto T, Shoji F, Shimokawa M, Akamine T, Takamori S, et al. Clinical significance of PD-L1 protein expression in surgically resected primary lung adenocarcinoma. J Thorac Oncol 2016;11(11):1879–90.

Published

2024-09-08