High expression of PD-L1 mainly occurs in non-small cell lung cancer patients with squamous cell carcinoma or poor differentiation

Sep 24, 2026

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The study investigates how programmed cell death protein 1 ligand 1 (PD-L1) expression relates to clinical features in non-small cell lung cancer (NSCLC), focusing on squamous cell carcinoma and poor differentiation. Using TCGA data for lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD), together with immunohistochemistry (IHC) analysis of 1,008 NSCLC patients, the work evaluates correlations between PD-L1 protein levels and pathological characteristics. Results show higher PD-L1 in LUSC and poor differentiation, supporting routine PD-L1 IHC testing in likely responders.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Introduction

Study purpose

Background on PD-L1 and NSCLC

Methods

TCGA analysis

Immunohistochemistry (IHC) study

Results

PD-L1 expression differences by subtype

Univariate and multivariate associations

Conclusion

Recommendation for routine PD-L1 IHC testing

ONCOLOGY RESEARCH 2023 31(3): 275-286 High expression of PD-L1 mainly occurs in non-small cell lung cancer patients with squamous cell carcinoma or poor differentiation LU LIU 1,2; BIN XIE 1,2; WEI ZHU 1,2; QIUYAN HE 1,2; JIANHUA ZHOU 1,2; SHUANG LIU3; YONGGUANG TAO4; DESHENG XIAO 1,2,* 1 Department of Pathology, Xiangya Hospital, Central South University, Changsha, China 2 Department of Pathology, School of Basic Medicine, Central South University, Changsha, China 3 Center for Medicine Research, Xiangya Hospital, Central South University, Changsha, China 4 Key Laboratory of Carcinogenesis and Cancer Invasion (Central South University), Ministry of Education, Cancer Research Institute, School of Basic Medicine, Central South University, Changsha, China Key words: NSCLC, PD-L1, Immunotherapy, LUSC, LUAD Abstract: Background: Lung cancer is one of the most lethal cancers worldwide, but studies have shown that the higher the expression of programmed cell death protein 1 ligand 1 (PD-L1) in non-small cell lung cancer (NSCLC), the more likely it will beneﬁt from anti-PD-L1 immunotherapy. The purpose of our study was to collect and analyze abundant clinical samples in order to provide evidence for clinicians and patients who might consider anti-PD-L1 immunotherapy while jointly formulating treatment plans. Methods: On the one hand, we obtained cases from The Cancer Genome Atlas (TCGA) database, including 498 lung squamous cell cancer (LUSC) patients and 515 lung adenocarcinoma (LUAD) patients. We studied the lung caner driver gene in LUSC and LUAD. On the other hand, PD-L1 expression was detected in lung cancer tissues of 1,008 NSCLC patients with immunohistochemistry staining (IHC), and we studied the correlation between PD-L1 protein expression and clinicopathological characteristics. Results: PD-L1 expression was higher in LUSC than in LUAD at the mRNA level. In univariate analysis, PD-L1 expression at the protein level was higher in patients who were males, were LUSC, were smokers, had a tumor diameter >3 cm, had poor differentiation, or had stages III~IV disease. In multivariate analysis, PD-L1 expression was higher in patients who were LUSC or in poor differentiation. Conclusion: In term of protein level, PD-L1 expression was higher in NSCLC patients who were LUSC or in poor differentiation. We recommend that PD-L1 IHC detection can be routinely performed in such populations that are likely to beneﬁt most from PD-L1 immunotherapy. Abbreviation HE Hematoxylin and eosin IHC Immunohistochemical SCLC Small cell lung cancer NSCLC Non-small cell lung cancer LUAD Lung adenocarcinoma LUSC Lung squamous cell carcinoma LCC Large cell cancer FDA Food and Drug Administration PD-L1 Programmed cell death protein 1 ligand 1 EGFR Epidermal growth factor receptor ALK Anaplastic lymphoma kinase PD-1 Programmed cell death protein 1 *Address correspondence to: Desheng Xiao, [xdsh96@csu.edu.cn](xdsh96@csu.edu.cn)[ ](xdsh96@csu.edu.cn)[Received: 06 December 2022](Received: 06 December 2022); [Accepted: 10 March 2023](Accepted: 10 March 2023); Published: 24 May 2023 TNM stage Tumor, Region lymph node, Metastasis stage WHO World Health Organization IASLC International Association for the Study of Lung Cancer TCGA The Cancer Genome Atlas TPS The tumor proportion score LN Lymph node Introduction Lung cancer is one of the major causes of cancer deaths worldwide. It is estimated that over the disease has killed more than 1.76 million individuals annually in recent years [1] . There are no obvious symptoms in early-stage lung cancer, thus the disease is typically discovered in the advanced stage. Hence, diagnosis and treatment play signiﬁcant roles in all research on lung cancer. With the exception of hematoxylin and eosin (HE) staining, Doi: [10.32604/or.2023.028227 www.techscience.com/journal/or](10.32604/or.2023.028227 www.techscience.com/journal/or) This work is licensed under a Creative Common

FAQs

What was the purpose of the study regarding PD-L1 in NSCLC?

The study aimed to collect and analyze abundant clinical samples to provide evidence on where anti-PD-L1 immunotherapy may benefit clinicians and patients, while helping inform treatment planning.

How were PD-L1 expression data obtained and analyzed?

PD-L1 was assessed using TCGA cases for LUSC and LUAD, and PD-L1 protein expression was measured in 1,008 NSCLC patients using immunohistochemistry (IHC). The study then analyzed correlations with clinicopathological characteristics.

Which patient groups showed higher PD-L1 expression?

Protein-level PD-L1 expression was higher in LUSC and in cases with poor differentiation, and univariate findings also linked higher PD-L1 with male sex, smoking status, larger tumor diameter, and advanced stages (III–IV).

What does the study recommend for clinical practice?

The study recommends routine PD-L1 IHC detection in populations likely to benefit most from PD-L1 immunotherapy.

Sep 24, 2026

Uploaded by Aurelia