Programmed cell death-ligand 1 expression and immunoscore in stage II and III non-small cell lung cancer patients receiving adjuvant chemotherapy
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Hidenobu Ishii1, Koichi Azuma1, Akihiko Kawahara2, Norikazu Matsuo1, Takaaki Tokito1, Takashi Kinoshita1, Kazuhiko Yamada1, Tetsuro Sasada3, Jun Akiba2 and Tomoaki Hoshino1
1Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
2Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
3Cancer Vaccine Center, Kanagawa Cancer Center Research Institute, Yokohama, Japan
Koichi Azuma, email: firstname.lastname@example.org
Keywords: non-small cell lung cancer, programmed cell death-ligand 1, immunoscore, tumor-infiltrating lymphocyte, adjuvant chemotherapy
Received: March 13, 2017 Accepted: May 22, 2017 Published: June 27, 2017
Programmed cell death 1 (PD-1) receptor–ligand interaction is a major pathway that is often hijacked by tumors to suppress immune control. Immunoscore (IS), a combinational index of CD3 and CD8 tumor-infiltrating lymphocyte (TIL) density in the tumor’s center and invasive margin, is a new prognostic tool suggested to be superior to conventional tumor-staging methods in various tumors. This retrospective study aimed to investigate the prevalence and prognostic roles of PD-ligand 1 (PD-L1) expression and IS in non-small cell lung cancer (NSCLC) patients receiving adjuvant chemotherapy. PD-L1 expression and TIL density were evaluated by immunohistochemical analysis in 36 patients with stage II and III NSCLC. Tumors with staining in over 1% of their cells were scored as positive for PD-L1 expression, and we determined the median number of CD3- and CD8-positive TILs as the cutoff point for TIL density. To determine IS, each patient was given a binary score (0 for low and 1 for high) for CD3 and CD8 density in both the tumor center and invasive margin region. PD-L1 expression in tumor cells was observed in 61.1% (22/36) of patients. PD-L1 expression was significantly associated with high IS, and highest IS tended to have a favorable disease-free survival.
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