PD‐L1 expression in resected lung adenocarcinoma: prevalence and prognostic significance in relation to the IASLC grading system

Aims Programmed death‐ligand 1 (PD‐L1) expression is a predictive biomarker for adjuvant immunotherapy and has been linked to poor differentiation in lung adenocarcinoma. However, its prevalence and prognostic role in the context of the novel histologic grade has not been evaluated. Methods We analy...

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Published in:Histopathology 2024-05, Vol.84 (6), p.1013-1023
Main Authors: Hwang, Soohyun, Hong, Tae Hee, Kim, Hong Kwan, Cho, Juhee, Lee, Genehee, Choi, Sangjoon, Park, Sehhoon, Lee, Se‐Hoon, Lee, Yoonseo, Jeon, Yeong Jeong, Lee, Junghee, Park, Seong Yong, Cho, Jong Ho, Choi, Yong Soo, Kim, Jhingook, Zo, Jae Il, Shim, Young Mog, Choi, Yoon‐La
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adenocarcinoma - genetics
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Adenocarcinoma of Lung - genetics
Adenocarcinoma of Lung - pathology
Adenocarcinoma of Lung - surgery
B7-H1 Antigen - genetics
B7-H1 Antigen - metabolism
Cancer
histologic grade
Humans
Immunohistochemistry
Immunotherapy
lung adenocarcinoma
Lung cancer
Lung Neoplasms - genetics
Lung Neoplasms - pathology
Lung Neoplasms - surgery
Male
PD-L1 protein
Prevalence
Prognosis
programmed death‐ligand 1
recurrence‐free survival
Retrospective Studies
Risk factors
Tumors
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Summary:Aims Programmed death‐ligand 1 (PD‐L1) expression is a predictive biomarker for adjuvant immunotherapy and has been linked to poor differentiation in lung adenocarcinoma. However, its prevalence and prognostic role in the context of the novel histologic grade has not been evaluated. Methods We analysed a cohort of 1233 patients with resected lung adenocarcinoma where PD‐L1 immunohistochemistry (22C3 assay) was reflexively tested. Tumour PD‐L1 expression was correlated with the new standardized International Association for the Study of Lung Cancer (IASLC) histologic grading system (G1, G2, and G3). Clinicopathologic features including patient outcome were analysed. Results PD‐L1 was positive (≥1%) in 7.0%, 23.5%, and 63.0% of G1, G2, and G3 tumours, respectively. PD‐L1 positivity was significantly associated with male sex, smoking, and less sublobar resection among patients with G2 tumours, but this association was less pronounced in those with G3 tumours. PD‐L1 was an independent risk factor for recurrence (adjusted hazard ratio [HR] = 3.25, 95% confidence intervals [CI] = 1.93–5.48, P 
ISSN:0309-0167
1365-2559
DOI:10.1111/his.15146