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

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 inconsisten...

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Main Authors: Shiwei Wang, Mingyue Xu, You Liu, Xiaoming Hou, Zhaofeng Gao, Jingjie Sun, Leilei Shen
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-10437-9
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author Shiwei Wang
Mingyue Xu
You Liu
Xiaoming Hou
Zhaofeng Gao
Jingjie Sun
Leilei Shen
author_facet Shiwei Wang
Mingyue Xu
You Liu
Xiaoming Hou
Zhaofeng Gao
Jingjie Sun
Leilei Shen
author_sort Shiwei Wang
collection DOAJ
description 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.
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spelling doaj-art-c0791b511bb84ccc9ac81fcea07069cb2025-08-20T03:42:22ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-10437-9PD-L1 expression and its association with clinicopathological and computed tomography features in surgically resected non-small cell lung cancer: a retrospective cohort studyShiwei Wang0Mingyue Xu1You Liu2Xiaoming Hou3Zhaofeng Gao4Jingjie Sun5Leilei Shen6Department of Interventional Radiology, Hainan Hospital of PLA General HospitalDepartment of General Surgery, Hainan Hospital of PLA General HospitalDepartment of Pathology, Hainan Hospital of PLA General HospitalDepartment of Radiology, First Medical Center of PLA General HospitalSchool of Medicine, Nankai UniversityDepartment of Oncology, Hainan Hospital of PLA General HospitalDepartment of Thoracic Surgery, Hainan Hospital of PLA General HospitalAbstract 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.https://doi.org/10.1038/s41598-025-10437-9Programmed death-ligand 1Non-small cell lung cancerClinicopathologyGenomic mutationComputed tomography
spellingShingle Shiwei Wang
Mingyue Xu
You Liu
Xiaoming Hou
Zhaofeng Gao
Jingjie Sun
Leilei Shen
PD-L1 expression and its association with clinicopathological and computed tomography features in surgically resected non-small cell lung cancer: a retrospective cohort study
Scientific Reports
Programmed death-ligand 1
Non-small cell lung cancer
Clinicopathology
Genomic mutation
Computed tomography
title PD-L1 expression and its association with clinicopathological and computed tomography features in surgically resected non-small cell lung cancer: a retrospective cohort study
title_full PD-L1 expression and its association with clinicopathological and computed tomography features in surgically resected non-small cell lung cancer: a retrospective cohort study
title_fullStr PD-L1 expression and its association with clinicopathological and computed tomography features in surgically resected non-small cell lung cancer: a retrospective cohort study
title_full_unstemmed PD-L1 expression and its association with clinicopathological and computed tomography features in surgically resected non-small cell lung cancer: a retrospective cohort study
title_short PD-L1 expression and its association with clinicopathological and computed tomography features in surgically resected non-small cell lung cancer: a retrospective cohort study
title_sort pd l1 expression and its association with clinicopathological and computed tomography features in surgically resected non small cell lung cancer a retrospective cohort study
topic Programmed death-ligand 1
Non-small cell lung cancer
Clinicopathology
Genomic mutation
Computed tomography
url https://doi.org/10.1038/s41598-025-10437-9
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