Research Information System
TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, vol.32, no.1, pp.84-92, 2024 (SCI-Expanded)
Background: In this study, we aimed to investigate the prognostic value
of programmed cell death protein 1 (PD-1), programmed cell death ligand
1 (PD-L1), and programmed cell death ligand 2 (PD-L2) expressions
on immune and cancer cells in terms of survival in patients with lung
adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
Methods: Between January 2000 and December 2012, a total of
191 patients (172 males, 19 females; mean age: 60.3±8.4 years;
range, 38 to 78 years) who were diagnosed with non-small cell lung
cancer and underwent anatomic resection and mediastinal lymph
node dissection were retrospectively analyzed. The patients were
evaluated in three groups including lung squamous cell carcinoma
(n=61), adenocarcinoma (n=66), and large-cell carcinoma (n=64).
The survival rates of all three groups were compared in terms of
immunohistochemical expression levels of PD-1, PD-L1, and PD-L2.
Results: The mean follow-up was 71.8±47.9 months. In all histological
subtypes, PD-1 expressions on tumor and immune cells were observed
in 33% (61/191) and in 53.1% (102/191) of the patients, respectively.
Higher expression levels of PD-L1 and PD-L2 at any intensity on
tumor and immune cells were defined only in lung adenocarcinomas,
and PD-L1 and PD-L2 values were detected in 36.4% (22/64) of these
patients. The PD-L1 expressions on tumor and immune cells were
observed in 41.7% (10/24) and 25% (6/24) of the patients, respectively.
The PD-L2 expressions on tumor and immune cells were detected in
16.7% (4/24) and 8.4% (2/24) of the patients, respectively. Univariate and
multivariate analyses revealed that PD-1 expression in tumor cells was
an independent prognostic factor in all histological subtypes.
Conclusion: Our study results suggest that PD-1 expression is
a poor prognostic factor for overall survival in patients with
completely resected adenocarcinoma, squamous cell carcinoma, and
large cell carcinoma.