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2022, Volume 38, Number 3, Page(s) 261-274     
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DOI: 10.5146/tjpath.2022.01572
Programmed Cell Death Ligand 1 Expression in Cytological and Surgical Non–Small Cell Lung Cancer Specimens in Association with EGFR Mutation and Overall Survival: A Single-Institution Experience
1Department of Pathology, Inonu University, Faculty of Medicine, MALATYA, TURKEY
2University of Health Sciences, Haydarpasa Numune Training and Research Hospital, ISTANBUL, TURKEY
3Department of Medical Oncology, BAU Medical Park Göztepe Hospital, ISTANBUL, TURKEY
Keywords: Epidermal growth factor receptor, Non-small cell lung cancer, Programmed cell death ligand-1, Survival

Objective: The aim of this study was to evaluate programmed cell death ligand-1 (PD-L1) expression and the relationship between driver mutations and survival analysis in advanced-stage non-small cell lung carcinoma (NSCLC).

Material and Method: A total of 122 advanced-stage NSCLC patients were included in this retrospective study. The patients were diagnosed based on cytological examination and histopathological analysis of biopsy or resection material that had undergone at least 1 molecular analysis. The expression of PD-L1 in tumors and tumor-infiltrating lymphocytes (TIL) was scored and compared with age, sex, organ, biopsy method, tumor subtype, driver mutation status, and overall survival data.

Results: There was no statistically significant difference between PD-L1-positivity and age, gender, location, pattern, or pathological diagnosis of the type of sample. When the threshold value for PD-L1 IHC evaluation was accepted as ≥1% and ≥50%, the rate of positivity was 19.7% and 7.4%, respectively.

Conclusion: Since there is a wide range of positivity rates reported in the literature, we could not reach a conclusion as to whether the PD-L1-positivity rate we observed was high or low. There is a need for comparative studies where the technique, clones, threshold values, and phases are homogenized. There is an inverse correlation between the EGFR-mutant population and PD-L1 positivity. In terms of overall survival, no relationship was found between PD-L1 positivity, the presence of TIL, and EGFR mutation status.

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