Background: Recent advances in perioperative immunotherapies have led to a new era in the perioperative treatment of resectable, non-small cell lung cancer (NSCLC). Although the choice of neoadjuvant, adjuvant or perioperative immunotherapy remains controversial, few reports have compared programmed death ligand-1 (PD-L1) expression as a biomarker between preoperative biopsy specimens and surgical specimens. Methods: We retrospectively reviewed consecutive patients with NSCLC whose preoperative biopsy specimens and surgical specimens were tested for PD-L1 (22C3) and PD-L1 (SP263), respectively, from June 2022 to February 2024. The three categorical classifications of PD-L1 expression (negative [<1%], low [1–49%], and high [≥50%]) were compared between the two tests. Results: Of the 33 patients, 13 patients had negative PD-L1 expression, 9 patients had low PD-L1 expression and 11 patients had high PD-L1 expression with preoperative biopsy specimens, while 18 patients had negative PD-L1 expression, 10 patients had low PD-L1 expression and 5 patients had high PD-L1 expression with surgical specimens. The concordance rate for the three categorical classifications of PD-L1 expression between the preoperative biopsy specimens and surgical specimens was 57.6%. Conclusions: PD-L1 expression may differ between preoperative biopsy specimens and surgical specimens. PD-L1 expression evaluated using small biopsy specimens may be largely influenced by chance due to intra-tumoral heterogeneity.
背景：围手术期免疫疗法的近期进展开启了可切除非小细胞肺癌（NSCLC）围手术期治疗的新纪元。尽管新辅助、辅助或围手术期免疫疗法的选择仍存争议，但关于术前活检标本与手术标本中程序性死亡配体-1（PD-L1）表达作为生物标志物的比较研究鲜有报道。方法：我们回顾性分析了2022年6月至2024年2月期间连续收治的NSCLC患者，这些患者的术前活检标本与手术标本分别进行了PD-L1（22C3）和PD-L1（SP263）检测。比较了两种检测方法中PD-L1表达的三级分类（阴性[<1%]、低表达[1–49%]和高表达[≥50%]）。结果：在33例患者中，术前活检标本显示13例患者PD-L1表达阴性，9例患者低表达，11例患者高表达；而手术标本显示18例患者PD-L1表达阴性，10例患者低表达，5例患者高表达。术前活检标本与手术标本之间PD-L1表达三级分类的一致性率为57.6%。结论：PD-L1表达在术前活检标本与手术标本间可能存在差异。由于肿瘤内异质性，通过小活检标本评估的PD-L1表达可能很大程度上受偶然因素影响。
肿瘤(癌症)患者之家