PD-L1 expression in pleural effusions of pulmonary adenocarcinoma and survival prediction: a controlled study by pleural biopsy

Abstract

PD-L1 expression in pleural effusions (PE) of lung adenocarcinoma (ADC) was compared with pleural biopsies and the positive expression in PE was correlated with survival time. The matched slices from same patient’s pleura and PE were collected which both were pathologically verified positive. Immunohistochemistry (IHC) was used to detect PD-L1 expression. A total of 51 eligible cases were enrolled, including 30 males and 21 females. The average age was (67.06 ± 12.10) years. PD-L1 expression wasn’t statistically significant in pleura and cell masses (P > 0.05) and the correlation was statistically significant (r = 0.585, P = 0.000). Using an IHC scores of 5 point as a cutoff, positive PD-L1 expression in the pleura was 11.63% and that in the cell masses was 23.26%, and difference was significant (P < 0.05). The correlation coefficient was 0.605. Among 35 cases underwent systemic anti-tumor treatment, the mean survival time with positive PD-L1 expression in PE was 17.370 ± 1.827 months, which was significantly shorter than that with the negative (29.944 ± 2.671 months) (χ2 = 4.507, P = 0.034). Positive PD-L1 expression in PE is higher than in the pleura and their correlation is well. It may predict the short survival time after systemic anti-tumor treatment.

The Clinical Significance of Soluble Programmed Cell Death-Ligand 1 (sPD-L1) in Patients With Gliomas

“…At present, the difficulties associated with performing biopsies hamper glioma diagnosis and therapeutic intervention, highlighting the need to discover non-invasive or minimally invasive biomarkers for early diagnosis and correct stratification (31). sPD-L1 can be detected in biofluids, providing a novel diagnostic test for a variety of tumors (32)(33)(34). In our previous study, elevated sPD-L1 levels in the serum were observed in preoperative patients with HGG.…”

Programmed death ligand 1 expression in EBUS aspirates of non–small cell lung cancer: Is interpretation affected by type of fixation?

“…A growing number of studies have now examined the variability of PD‐L1 expression between different types of NSCLC specimens, which include bronchial washings, aspirates of the primary tumor or its metastases (including cells from pleural and pericardial fluids), endoscopic and transthoracic needle biopsies, incisional biopsies of tumor deposits (usually in skin or superficial lymph nodes), and entire resected tumors . Unfortunately, the specimens compared in these studies have almost always differed not only in their nature (cytology vs histology) but also in their site of origin, and the well‐documented heterogeneity of PD‐L1 expression within and between tumor deposits has made the precise basis of any variability difficult to determine.…”

“…Although much has now been published about the variability of PD‐L1 expression between different types of specimens of NSCLC, little attention has been paid specifically to the important question of the effect of fixation. In view of this, we thought it would be of value to determine whether there is any difference in PD‐L1 expression between EBUS‐guided aspirates of NSCLC fixed in alcohol‐based fixatives and those fixed in NBF, the standard laboratory fixative for histology specimens.…”

Molecular Testing on Pleural Fluid Samples

“…33,34 PD-L1 expression in pleural effusions compared with pleural biopsies in the same patient by IHC was studied by Xu et al 35,36 In total, 51 cases were reviewed with no difference detected in expression with a threshold of at least 10% PD-L1 expression (65 vs. 65%). 29 However, a difference was detected when a threshold of >50% expression was utilized (12 vs. 24%, p ¼ 0.007) with higher detection in the pleural biopsy specimen. Heymann et al also compared PD-L1 expression in 214 specimens collected from 188 patients with NSCLC among cytology, small biopsy, and surgically resected biopsies, and reported that PD-L1 testing done on pleural fluid samples had an accuracy of 77% compared with histological samples.…”

“…15 Although the rate of detection was higher in tissue samples (34%) compared with MPE (30%), the difference was not statistically different. [26][27][28][29] Carter et al analyzed 27 cases of NSCLC with MPE after excluding 14 cases due to inadequate tumor cellularity and detected a genetic aberration in 59% of samples (AKT, BRAF, EGFR, ERBB2, KRAS, NRAS, PIK3CA). 17,30 Liu et al evaluated 192 advanced cases of NSCLC with both primary tumor and MPE samples for EGFR with no difference in detection at 62 and 59%, respectively.…”