小样本,大见解:第三级机构的PD-L1经验
Nuray Tezcan1, Lal Sude Gucer2,3, Aslı Aydın4
1Koç University, School of Medicine, Department of Pathology, Istanbul, Turkey.
International journal of surgical pathology
|July 8, 2025
概括
小型活检和细胞块可靠地评估非小细胞肺癌 (NSCLC) 中的PD-L1表达,与较大的切除样本相比. 这支持它们在NSCLC患者的及时免疫疗法决策中使用它们.
科学领域:
- 在瘤学瘤学.
- 病理学 病理学 病理学
- 免疫治疗是一种免疫疗法.
背景情况:
- PD-L1表达对于指导非小细胞肺癌 (NSCLC) 免疫治疗至关重要.
- 样本类型可以影响PD-L1表达评估的准确性.
- 在PD-L1测试中的变量会影响治疗决策.
研究的目的:
- 为了比较小 (活检,细胞块) 和大 (切除) NSCLC样本之间的PD-L1表达.
- 为了评估PD-L1得分的观察者间变异性.
- 为了评估PD-L1评分趋势的稳定性.
主要方法:
- 从2018-2022年对494名NSCLC患者进行PD-L1 (Ventana SP263) 测试的回顾性分析.
- 记录了样本类型,瘤亚型,PD-L1瘤比例得分 (TPS) 和报告病理学家.
- 分析了观察者之间的变异性,并比较了来自43名患者的匹配细胞块和切除样本.
主要成果:
- 在小型和大型NSCLC样本之间没有发现PD-L1TPS类别的显著差异 (p=0.326).
- 在病理学家 (p=0.260) 和年 (p=0.250) 之间,PD-L1 TPS分布保持一致.
- 在匹配的样本中,细胞块和切除标本之间观察到高一致性 (κ=0.892).
结论:
- 小型活检和细胞块提供可靠的PD-L1评估,与切除标本相比.
- 这些发现支持用于NSCLC的PD-L1测试的小样本的临床实用性.
- 使用较小的样本可以促进NSCLC患者更早地获得免疫治疗.
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