J Pathol Transl Med.  2021 Nov;55(6):398-405. 10.4132/jptm.2021.08.08.

Programmed death-ligand 1 expression and tumor-infiltrating lymphocytes in non-small cell lung cancer: association with clinicopathologic parameters

• Garg G
• Prasad KT
• Singh N
• Gupta P
• Muthu V
• Das A
• Bal A

• KMID: 2522441
• DOI: http://doi.org/10.4132/jptm.2021.08.08

Abstract

Background
Data on the prevalence of programmed death-ligand 1 (PD-L1) expression and tumor-infiltrating lymphocytes (TILs) in non–small cell lung cancer (NSCLC) and their clinical significance in Indian patients are limited.
Methods
Newly diagnosed NSCLC cases (adenocarcinoma or squamous cell carcinoma [SqCC] histology) were included in the present study. The TILs were evaluated based on morphology on hematoxylin and eosin–stained slides. PD-L1 expression in tumors was assessed using immunohistochemistry with rabbit monoclonal antibody (SP263) on the Ventana automated immunostainer. Tumors with PD-L1 expression > 50% on tumor cells were considered PD-L1–positive. Tumors in which TILs occupy > 25% of stroma were considered to have high TILs. The association of PD-L1 expression and TILs with various clinical parameters including overall survival (OS) was investigated.
Results
The present study included 128 cases of NSCLC (67 adenocarcinoma, 61 SqCC). PD-L1 positivity was observed in 17.2% of the patients with NSCLC. Baseline characteristics of PD-L1–positive subjects were similar to PD-L1–negative subjects except for a higher prevalence of liver metastasis (18.2% vs. 2.8%; p = .018) and a higher probability of diagnosis from extrapulmonary biopsies. High TILs were observed in 26.6% of the subjects. However, PD-L1 expression and high TIL did not affect OS.
Conclusions
PD-L1 positivity and high TILs were observed in 20% and 25% of the patients with NSCLC, respectively, however, neither were predictors of survival in SqCC.

Keyword

Lung neoplasms; Non-small cell lung carcinoma; PD-L1; Immunotherapy; Tumor-infiltrating lymphocytes

Figure

• 

  Fig. 1 Photomicrographs (programmed death-ligand 1 [PD-L1] staining using SP263 clone) showing positive control (PD-L1 staining in placenta) (A), TC2 (PD-L1 expression on > 50% of tumor cells [TCs]) (B), TC1 (PD-L1 expression on 1%–50% TCs) (C), and TC0 (PD-L1 expression on < 1% of TCs) (D).

• 

  Fig. 2 Photomicrographs (× 200) of hematoxylin and eosin staining showing TIL0 (0%–5% of tumor stroma occupied by tumor-infiltrating lymphocytes [TILs]) (A), TIL3 (> 50% of tumor stroma occupied by TILs) (B).

• 

  Fig. 3 Kaplan-Meir plots for overall survival (OS). OS of programmed death-ligand 1 (PD-L1)–positive subjects was not different from PD-L1–negative subjects. The median (95% confidence interval) OS was 7.6 months (6.5–8.8) in subjects who were PDL1–negative compared with 8.5 months (1.1–16.0) in subjects who were PD-L1-positive (log-rank p = .584).

Reference

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