支气管内超声引导下的经支气管针吸术和 PD-L1 产量

IF 4.6 2区医学 Q1 RESPIRATORY SYSTEM

Lung Pub Date : 2024-04-18 DOI:10.1007/s00408-024-00692-4

Lara M. Khoury, Kristin N. Sheehan, William I. Mariencheck, Katherine A. Gershner, Matthew Maslonka, Angela G. Niehaus, Scott Isom, Christina R. Bellinger

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引用次数: 0

摘要

目的免疫疗法是通过靶向 PD-1/PD-L1 检查点信号通路治疗晚期非小细胞肺癌 (NSCLC) 的主要方法，尤其是在表达高水平 PD-L1 的肿瘤中（Jug 等人，发表于 J Am Soc Cytopathol 9:485-493, 2020；Perrotta 等人，发表于 Chest 158：1230-1239, 2020).支气管内超声引导下经支气管针吸术（EBUS-TBNA）是一种微创方法，可获取组织用于不可切除肿瘤的分子研究，包括PD-L1分析（Genova等，发表于Front Immunol 12: 799455, 2021；Wang等，发表于Ann Oncol 29: 1417-1422, 2018）。本研究旨在评估 EBUS-TBNA 细胞学标本中 PD-L1 评估的充分性。方法回顾性收集 2017 年至 2021 年间因疑似肺癌活检而接受 EBUS-TBNA 的患者数据。对NSCLC阳性样本进行PD-L1表达检测。EBUS由经验丰富的医生进行，并遵循至少从阳性病灶中抽吸五次的机构指南。结果分析涉及 387 例 NSCLC 病例（149 例鳞状细胞、191 例腺癌、47 例不明原因）。在 263 份进行 PD-L1 检测的 EBUS-TBNA 标本中，有 237 份（90.1%）被认为符合要求。虽然84%的标本遵守了检测方案，但遵守方案并没有带来更好的结果。与腺癌（87.6%）相比，鳞状细胞癌（93.2%）的 PD-L1 适当性明显更高。在两种癌症类型中，抽吸次数和镇静类型与PD-L1充分性无关，但病灶大小和位置对腺癌有显著影响。腺癌的PD-L1表达率（68%）高于鳞癌（48%）。结论EBUS-TBNA为评估PD-L1等免疫疗法标记物提供了很高的收益率，无论NSCLC亚型、病灶大小或位置如何，其充分性都令人满意。

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Endobronchial Ultrasound Guided Transbronchial Needle Aspiration and PD-L1 Yields

Purpose

Immunotherapy is a leading approach for treating advanced non-small cell lung cancer (NSCLC) by targeting the PD-1/PD-L1 checkpoint signaling pathway, particularly in tumors expressing high levels of PD-L1 (Jug et al. in J Am Soc Cytopathol 9:485–493, 2020; Perrotta et al. in Chest 158: 1230–1239, 2020). Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive method to obtain tissue for molecular studies, including PD-L1 analysis, in unresectable tumors (Genova et al. in Front Immunol 12: 799455, 2021; Wang et al. in Ann Oncol 29: 1417–1422, 2018). This study aimed to assess the adequacy of PD-L1 assessment in EBUS-TBNA cytology specimens.

Methods

Data was collected retrospectively from patients who underwent EBUS-TBNA between 2017 and 2021 for suspected lung cancer biopsy. Samples positive for NSCLC were examined for PD-L1 expression. EBUS was performed by experienced practitioners, following institutional guidelines of a minimum of five aspirations from positively identified lesions. Sample adequacy for molecular testing was determined by the pathology department.

Results

The analysis involved 387 NSCLC cases (149 squamous cell, 191 adenocarcinoma, 47 unspecified). Of the 263 EBUS-TBNA specimens tested for PD-L1, 237 (90.1%) were deemed adequate. While 84% adhered to the protocol, adherence did not yield better results. Significantly higher PD-L1 adequacy was observed in squamous cell carcinomas (93.2%) compared to adenocarcinoma (87.6%). The number of aspirations and sedation type did not correlate with PD-L1 adequacy in either cancer type, but lesion size and location had a significant impact in adenocarcinomas. Adenocarcinoma exhibited higher PD-L1 expression (68%) compared to squamous cell carcinoma (48%).

Conclusion

EBUS-TBNA offers high yields for assessing immunotherapy markers like PD-L1, with satisfactory adequacy regardless of NSCLC subtype, lesion size, or location.

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来源期刊

Lung 医学-呼吸系统

CiteScore

9.10

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.