Mustafa GÜRBÜZ, Elif Berna KÖKSOY, Koray CEYHAN, Adnan AYDINER, İzzet DOĞAN, Erman AKKUŞ, Ahmet DEMİRKAZIK, Güngör UTKAN, Pınar KUBİLAY TOLUNAY, Ender KALACI, Hilal ÖZAKINCI, Serpil DİZBAY SAK, Tolga BAĞLAN

İleri evre küçük hücreli dışı akciğer kanserinde klinikopatolojik parametreler ile PD-L1 ekspresyon düzeyi arasındaki ilişki

Giriş: Programlanmış ölüm ligandı 1 (PD-L1) ekspresyon düzeyleri ile ilgili klinikopatolojik parametreler çeşitli çalışmalarda araştırılmıştır. Ancak, bu çalışmaların sonuçları farklı popülasyonlarda çelişkili ve değişkendir. Bu çalışma, ileri evre küçük hücreli dışı akciğer kanseri hastalarında klinikopatolojik parametrelerin PD-L1 ekspresyon düzeyi ile ilişkisini araştırmayı amaçlamıştır. Materyal ve Metod: İleri evre küçük hücreli dışı akciğer kanseri tanısı olan hastalar retrospektif olarak çalışmaya dahil edildi. Klinikopatolojik parametrelerin verileri toplandı. PD-L1 ekspresyon seviyeleri (%0, %1-50 ve >%50) ile ilişkili klinikopatolojik parametreler tek değişkenli ve çok değişkenli olarak analiz edildi. Bulgular: Toplam 384 hasta çalışmaya dahil edildi. Tümör hücrelerinde PD-L1 ekspresyonu sırasıyla hastaların %41,4’ünde %1-50 ve %23,4’ünde >%50 idi. Hastaların %35,2’sinde PD-L1 ekspresyonu saptanmadı. Tek değişkenli analizde, PD-L1 ekspresyon seviyeleri ile metastatik bölge sayısı, kanser alt tipi, tanı materyal tipi, trombosit sayısı ve LDH seviyesinin istatistiksel olarak anlamlı düzeyde ilişkili olduğu gösterildi. PD-L1 ekspresyonu >%50 olan tümörlerde adenokarsinom sıklığı, PD-L1 ekspresyonu olmayanlara göre daha yüksekti ve fark istatistiksel olarak anlamlıydı (p= 0,04, katsayı= 0,3, %95 GA 0,09-0,94). PD-L1 ekpresyon düzeyi %1-50 ve >%50 karşılaştırıldığında tanı materyali olarak sitoloji %1-50 grupta anlamlı olarak fazlaydı (p= 0,02, katsayı= 2,2, %95 GA= 1,08-4,46). Sonuç: Bizim çalışmamızda klinikopatolojik parametrelerin çoğu PD-L1 düzeyi ile ilişkili değildi. Histolojik alt tip ve tanı materyali, PD-L1 ekspresyonun düzeyini etkileyebilir.

The relationship between clinicopathological parameters and PD-L1 expression level in advanced stage non-small cell lung cancer

Introduction: Clinicopathological parameters related to programmed death ligand 1 (PD-L1) expression levels have been investigated in several studies. However, the results of these studies are conflicting and vary in different populations. This study aimed to investigate the relation of clinicopathological parameters with PD-L1 expression level in advanced stage non-small cell lung cancer patients. Materials and Methods: The patients diagnosed with non-small cell lung cancer were enrolled, retrospectively. The data of clinicopathological parameters was collected. Clinicopathological parameters in relation to PD-L1 expression levels (0%, 1-50%, and >50%) were analyzed as univariable and multivariable. Results: In total, 384 patients were enrolled. PD-L1 expression in tumor cells was between 1-50%, and >50% in 41.4%, and 23.4% of patients, respectively. There was no PD-L1 expression in 35.2% of the patients. In univariable analysis, we found that the parameters associated with PD-L1 expression levels revealed that metastatic site number, the subtype of cancer, diagnostic material type, platelet number, and LDH level were statistically significant. Adenocarcinoma frequency was higher in tumors that had PD-L1 expression >50% than in tumors that did not express PD-L1 and the difference was statistically significant (p= 0.04, coefficient= 0.3, 95% CI 0.09-0.94). Cytology as diagnostic material was significant in PD-L1 level 1-50% comparing to >50% (p= 0.02, coefficient= 2.2, 95% CI= 1.08-4.46). Conclusion: According to the results of our study, many of the clinicopathological parameters are not related to the PD-L1 level. The histological subtype and diagnostic material may affect the level of PD-L1 expression.

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