Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 7;15(1):24323.
doi: 10.1038/s41598-025-10437-9.

PD-L1 expression and its association with clinicopathological and computed tomography features in surgically resected non-small cell lung cancer: a retrospective cohort study

Shiwei Wang #  1 , Mingyue Xu #  2 , You Liu  3 , Xiaoming Hou  4 , Zhaofeng Gao  5 , Jingjie Sun  6 , Leilei Shen  7
Affiliations

PD-L1 expression and its association with clinicopathological and computed tomography features in surgically resected non-small cell lung cancer: a retrospective cohort study

Shiwei Wang et al. Sci Rep. .

Abstract

Although some studies have assessed the correlation between clinicopathological features and programmed death-ligand 1 (PD-L1) in patients with non-smallcell lung cancer (NSCLC), few studies have focused on computed tomography (CT) signs. The results of some previous studies are inconsistent and contradictory. Therefore, this study aimed to analyze the clinicopathological and CT features of NSCLC patients with different PD-L1 expression levels. This retrospective analysis included 911 NSCLC patients who undergone pulmonary resection, and most of them were early-stage. PD-L1 expression was assessed by immunohistochemistry with the Dako PD-L1 22C3 pharmDx kit. Clinicopathological features and CT signs were investigated according to different PD-L1 expression levels. The prevalence of PD-L1 expression in the resected NSCLC patients was 46.9% (427/911), with 381 patients low expression (41.8%) and 46 patients high expression (5%). Male sex, current smoking status, higher positron emission tomography-computed tomography (PET-CT) SUVmax, and elevated serum carcinoembryonic antigen levels were more frequently observed in patients with high PD-L1 expression. The frequencies of squamous cell carcinoma type, spread through air space (STAS), TP53 mutations, advanced pathological stages, and micropapillary/solid subtype were significantly higher in patients with PD-L1 positive tumors (TPS ≥ 1%) than in those with PD-L1 negative tumors (TPS < 1%). ALK rearrangement was higher in patients with low-expression, and PD-L1-positive patients had bigger tumor diameter. The proportion of solid nodules and consolidation to tumor were higher in high-expression than those in the low- or negative expression PD-L1 patients. Regarding structural characteristic features, there were no differences in the frequency of irregular borders, pleural retraction, air bronchograms, bubble-like lucency or cavities, and vascular convergence among the three groups. The frequency of lobulated margins and spiculation was significantly higher in patients with PD-L1 positive tumors than in those with PD-L1 negative tumors. Patients with PD-L1 expression in NSCLC often exhibit certain clinicopathological characteristics. CT features may not reliably correlate with PD-L1 expression across different stages of lung cancer. Immunohistochemistry (IHC), using relevant kits, remains essential for further evaluation of PD-L1 expression levels.

Keywords: Clinicopathology; Computed tomography; Genomic mutation; Non-small cell lung cancer; Programmed death-ligand 1.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The study was performed in accordance with the guidelines for Good Clinical Practice and the principles of the Declaration of Helsinki, and was approved by the Ethics Committee of the Chinese People’s Liberation Army General Hospital(S2024-351-01). The requirement for individual informed consent was waived by the ethics committee of the PLA General Hospital, as this was a retrospective study.

Figures

Fig. 1
Fig. 1
Patients flow diagram.
Fig. 2
Fig. 2
Representative IHC images of PD-L1 expression in NSCLC. (A) Negative staining for PD-L1 (TPS < 1%), (B) weakly positive membrane staining for PD-L1 (TPS 1–49%), and (C) strongly positive membrane staining for PD-L1 (TPS ≥ 50%).
Fig. 3
Fig. 3
Representative CT images of PD-L1 expression in NSCLC. (A) Negative, (B) TPS 1–49%, and (C) TPS ≥ 50%.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Siegel, R. L., Miller, K. D. & Jemal, A. Cancer statistics, 2022. CA Cancer J. Clin.72 (1), 7–33 (2022). - PubMed
    1. Felip, E. et al. IMpower010 investigators. Adjuvant Atezolizumab after adjuvant chemotherapy in resected stage IB-IIIA non-small-cell lung cancer (IMpower010): a randomised, multicentre, open-label, phase 3 trial. Lancet9 (10308), 1344–1357 (2021). - PubMed
    1. O’Brien, M. et al. EORTC-1416-LCG/ETOP 8–15 – PEARLS/KEYNOTE-091 investigators. Pembrolizumab versus placebo as adjuvant therapy for completely resected stage IB-IIIA non-small-cell lung cancer (PEARLS/KEYNOTE-091): an interim analysis of a randomised, triple-blind, phase 3 trial. Lancet Oncol.23 (10), 1274–1286 (2022). - PubMed
    1. Mok, T. S. K. et al. KEYNOTE-042 investigators. Pembrolizumab versus chemotherapy for previously untreated, PD-L1-expressing, locally advanced or metastatic non-small-cell lung cancer (KEYNOTE-042): a randomised, open-label, controlled, phase 3 trial. Lancet393 (10183), 1819–1830 (2019). - PubMed
    1. Tang, Q. et al. The role of PD-1/PD-L1 and application of immune-checkpoint inhibitors in human cancers. Front. Immunol.13, 964442 (2022). - PMC - PubMed

MeSH terms