Programmed Death Ligand 1 Expression in Lung Adenocarcinoma: An Analysis of the Histomorphological Features
Saumya Shukla1, Nidhi Anand1, Rahul Kumar Pandey1
1Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Background:
Immunotherapy is now a vital target therapy in the advanced cases of lung adenocarcinoma. The outstanding result of therapies with medications that inhibit the interaction of programmed death ligand 1 with programmed death protein 1 has revolutionarized prognostic treatment regimes.
Aims:
The study was undertaken with the objectives to analyze the detailed histomorphological features of adenocarcinoma lung with programmed death ligand-1 (PD-L1) expression in tumor cells and to compare the histomorphological features with PD-L1 negative group.
Materials And Methods:
The present study is a retrospective case series with 100 cases of non-small cell lung cancer-adenocarcinoma phenotype in which testing for PD-L1 had been done using immunohistochemistry. Detailed histomorphological analysis and comparison was performed for both the PD-L1 positive and negative phenotype.
Results:
Histomorphological features of 25 cases with positive PD-L1 positivity in the tumor cells and 75 cases that were negative for PD-L1 were analyzed. The most frequent pattern in the category that was PD-L1 positive was singly scattered cells or loose clusters present in 84% cases followed by solid nests that was identified in 60% cases. The presence of solid nests in the PD-L1 positive category was statistically significant (P = 0.018). Mucin was identified in 24% cases, and tumor necrosis was documented in 60% cases with PD-L1 positivity. In the cluster that was PD-L1 positive, 92% cases had moderate-to-severe nuclear pleomorphism.
Conclusion:
The identification of histomorphological patterns and characteristics may aid in triaging cases that have the likelihood to harbor PD-L1-positive phenotype, which has predictive and prognostic outcome.
Insights
This study analyzed lung adenocarcinoma histomorphology and programmed death ligand-1 (PD-L1) expression. Identifying specific patterns may help predict PD-L1 positivity for better treatment strategies.
Area of Science:
- Oncology
- Pathology
Background:
- Immunotherapy, particularly targeting programmed death ligand-1 (PD-L1) and programmed death protein 1 (PD-1), is a crucial therapy for advanced lung adenocarcinoma.
- This interaction inhibition has significantly improved treatment outcomes and prognostic strategies.
Purpose of the Study:
- To investigate the detailed histomorphological features of lung adenocarcinoma with PD-L1 expression.
- To compare these features between PD-L1 positive and negative tumor cell groups.
Main Methods:
- A retrospective analysis of 100 non-small cell lung cancer-adenocarcinoma cases was conducted.
- Immunohistochemistry was used to test for PD-L1 expression.
- Detailed histomorphological analysis and comparison were performed for PD-L1 positive (25 cases) and negative (75 cases) groups.
Main Results:
- In PD-L1 positive cases, singly scattered cells or loose clusters (84%) were most frequent, followed by solid nests (60%).
- The presence of solid nests was statistically significant in PD-L1 positive cases (P=0.018).
- Tumor necrosis (60%) and moderate-to-severe nuclear pleomorphism (92%) were also noted in PD-L1 positive cases.
Conclusions:
- Histomorphological patterns can potentially aid in identifying lung adenocarcinoma cases likely to be PD-L1 positive.
- This identification may assist in predicting patient outcomes and guiding treatment decisions.
