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Purpose <p>The expression of PD-L1 is linked to lung cancer severity; however, its prognostic value after resection is unclear. In this study, we investigated its role in resected lung cancers.</p> Methods <p>We analyzed 658 patients with stage pIA–IIIA NSCLC who underwent complete resection. We assessed the PD-L1 expression by stage and its link to cancer severity, focusing further on its prognostic impact in resected stage I cell lung cancer.</p> Results <p>The high expression of PD-L1 increased with disease progression (13.0% in IA to 36.2% in III). In stage I non-small cell lung cancer, elevated PD-L1 expression levels were more common in patients with serum CEA levels ≥ 5 (26.0%), SUVmax ≥ 5 (26.7%), and squamous cell carcinoma (41.5%). PD-L1-negative patients showed a better prognosis than PD-L1-positive patients, even with the use of immune checkpoint inhibitors following relapse (5-year OS: 94.3% vs. 83.2%, p &lt; 0.01).</p> Conclusion <p>The expression of PD-L1 in lung cancer appears to be associated with oncological severity and may influence the prognosis of early-stage disease. Additionally, in early-stage lung cancer, immune checkpoint inhibitors may not fully compensate for the negative prognostic impact of the high expression of PD-L1.</p>

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PD-L1 expression correlates with the oncological severity and prognosis of early-stage lung cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月4日

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  • Ken Onodera,
  • Hirotsugu Notsuda,
  • Sakiko Kumata,
  • Tatsuaki Watanabe,
  • Yui Watanabe,
  • Takaya Suzuki,
  • Takashi Hirama,
  • Hisashi Oishi,
  • Yoshinori Okada

摘要

Purpose

The expression of PD-L1 is linked to lung cancer severity; however, its prognostic value after resection is unclear. In this study, we investigated its role in resected lung cancers.

Methods

We analyzed 658 patients with stage pIA–IIIA NSCLC who underwent complete resection. We assessed the PD-L1 expression by stage and its link to cancer severity, focusing further on its prognostic impact in resected stage I cell lung cancer.

Results

The high expression of PD-L1 increased with disease progression (13.0% in IA to 36.2% in III). In stage I non-small cell lung cancer, elevated PD-L1 expression levels were more common in patients with serum CEA levels ≥ 5 (26.0%), SUVmax ≥ 5 (26.7%), and squamous cell carcinoma (41.5%). PD-L1-negative patients showed a better prognosis than PD-L1-positive patients, even with the use of immune checkpoint inhibitors following relapse (5-year OS: 94.3% vs. 83.2%, p < 0.01).

Conclusion

The expression of PD-L1 in lung cancer appears to be associated with oncological severity and may influence the prognosis of early-stage disease. Additionally, in early-stage lung cancer, immune checkpoint inhibitors may not fully compensate for the negative prognostic impact of the high expression of PD-L1.