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High expression of programmed cell death 1 ligand 1 in lung adenocarcinoma is a poor prognostic factor particularly in smokers and wild‐type epidermal growth‐factor receptor cases
Author(s) -
Mori Shohei,
Motoi Noriko,
Ninomiya Hironori,
Matsuura Yosuke,
Nakao Masayuki,
Mun Mingyon,
Okumura Sakae,
Nishio Makoto,
Morikawa Toshiaki,
Ishikawa Yuichi
Publication year - 2017
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12489
Subject(s) - epidermal growth factor receptor , adenocarcinoma , immunohistochemistry , lung , medicine , oncology , etiology , pathology , epidermal growth factor , lung cancer , adenocarcinoma of the lung , survival analysis , receptor , biology , cancer research , cancer
A clinical implication of programmed cell death 1 ligand 1 (PD‐L1) expression in lung adenocarcinoma has not been well established. We evaluated PD‐L1 expression immunohistochemically on 296 surgically resected lung adenocarcinomas to investigate a clinical implication of PD‐L1 expression especially in terms of smoking history and epidermal growth‐factor receptor (EGFR) mutation status. Patients were classified into high‐ and low‐PD‐L1 expression groups. The high‐expression group ( n = 107) showed a significantly higher proportion of smokers and poor differentiation compared with the low‐expression group ( n = 189). Survival analysis showed that the prognosis of the high‐expression group was worse in overall survival than that of the low‐expression group (3‐year overall survival 85 vs. 94%, P = 0.005). Stratified survival analyses showed that the prognoses of the high‐expression group were worse than those of the low‐expression group in both strata of smokers and wild‐type EGFR ( P = 0.009 and P = 0.007, respectively). We found that high PD‐L1 expression was a poor prognostic factor in the smokers or the patients with wild‐type EGFR, whereas it was not the case in those who never smoked or those with EGFR mutation, implying the importance of adenocarcinoma driver mutations and etiology.