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Updated: May 26, 2026
Semi-automatic PD-L1 Characterization and Enumeration of Circulating Tumor Cells from Non-small Cell Lung Cancer Patients by Immunofluorescence
Published on: August 14, 2019
Comprehensive characterization of non-small cell lung cancer of different PD-L1 expression classes: a study of 1,038
Zixian Xie1, Jinghao Liang1, Zishan Huang2
1Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou, China.
Background:
Programmed death ligand 1 (PD-L1) is one of the most well-established biomarker for predicting response to immunotherapy in non-small cell lung cancer (NSCLC). Multiple clinicohistologic and genetic features have been proposed as correlates of PD-L1 expression. However, few studies have investigated the relevance of immune cell infiltration or chromosomal arm-level alterations. This study aimed to comprehensively characterize the clinicopathologic, genomic, and immunologic landscape across different PD-L1 expression classes in 1,038 Chinese patients with NSCLC.
Methods:
We retrospectively included 1,038 NSCLC patients who had genomic profiles and PD-L1 Tumor Proportion Score (TPS) by the 22C3 assay. Multiplex immunohistochemistry (IHC) was used to assess immune cell filtration. Association analyses were performed to identify clinicopathologic and molecular features associated with PD-L1 expression.
Results:
The negative (TPS <1%), low (1-49%), and high (≥50%) PD-L1 expression groups accounted for 25.2%, 43.2%, and 31.5% of cases, respectively. PD-L1 expression was positively associated with puncture biopsy specimens, male sex, squamous histology, ALK fusions, KRAS G12/13X mutations, BRAF V600E, ROS1 fusion, MET exon 14 skipping, and other aberrant genes. Negative correlates included driver-positive status, EGFR L858R, EGFR exon 19 deletions, ERBB2 exon 20 insertions, and others. Multiple arm-level amplifications and losses were associated with PD-L1 expression. Moreover, patients with high PD-L1 expression showed significantly increased tumor infiltration of CD3+CD8+ cells compared with other groups.
Conclusions:
This study enriches the current volume of evidence on histopathologic, genetic, immunologic correlates of PD-L1 expression and, to our knowledge, is the first comprehensive analysis of arm-level alterations. Further studies are warranted to validate these finding and to determine their associations with clinical outcomes.
