Association of CTLA4 and PD-L1 immunohistchemical expression with various clinicopathological parameters and survival in non–small-cell lung cancer

Background : Lung carcinoma is one of the most popular solid malignancies and is one of the most important sources of death all over the world. Unfortunately, drug resistance led to poor prognosis, high rate of recurrence and decreased survival (OS) in sick people have non-small cell lung cancer (NSCLC). Both CTLA-4 and PDL-1 checkpoint inhibitors have resulted in increased patient survival in a number of studies of melanoma and renal cell carcinoma. The purpose of this study aimed to detect CTLA-4 and PD-L1immunoexpression in relation to various clinicopathological parameters and survival in NSCLC patients. Material and methods: Forty cases of NSCLC patients underwent surgical resection or bronchoscopy biopsy with no history of radiotherapy or chemotherapy were included. Results: Positive expression of CTLA4 was recognized in 31 (77.5%) of NSCLC patients . Positive PD-L1 results were found in 28 (70%) of NSCLC patients. There were significant relations between CTLA4 expression and high tumor grade (p value = 0.024) & tumor stage (p value = 0.010). There were significant relations between expression of PD-L1 and high tumor grade (p value = 0.012), tumor stage (p value = 0.012), histologic type (p value = 0.016), and smoking status (p value = 0.041). Although no significant relation was noted between either result of PD-L1 or CTLA4 and survival, positive expression was associated with shorter survival. (p value=0.816, p value= 0.130). Elevated serum PD-L1 level had been elevated in patients with positive PD-L1 expression (p < 0.001). Conclusions: CTLA4 and PD-L1are strongly associated with the prognosis of NSCLC. Their immunohistochemical expression may help in recognizing the adequate therapy for NSCLC patients.