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Higher concordance of PD-L1 expression between biopsies and effusions in epithelioid than in nonepithelioid pleural mesothelioma

Mansour, Mohammed S I LU orcid ; Seidal, Tomas ; Mager, Ulrich ; Dobra, Katalin LU ; Brunnström, Hans LU orcid and Dejmek, Annika LU (2021) In Cancer Cytopathology 129(6). p.468-478
Abstract

BACKGROUND: Malignant mesothelioma (MM) is a therapy-resistant tumor, often causing an effusion. Drugs targeting the programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathway have shown promising results, but assessment of PD-L1 expression to select patients for therapy has mainly been performed on histologic tissue samples. In a previous study, we showed that MM effusions are suitable for PD-L1 assessment with results comparable to those reported in histologic studies, but no studies have compared PD-L1 expression in histologic and cytologic samples.

METHODS: PD-L1 expression was determined immunohistochemically (clone 28-8) in 61 paired samples of effusions and biopsies from patients with pleural MM, obtained... (More)

BACKGROUND: Malignant mesothelioma (MM) is a therapy-resistant tumor, often causing an effusion. Drugs targeting the programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathway have shown promising results, but assessment of PD-L1 expression to select patients for therapy has mainly been performed on histologic tissue samples. In a previous study, we showed that MM effusions are suitable for PD-L1 assessment with results comparable to those reported in histologic studies, but no studies have compared PD-L1 expression in histologic and cytologic samples.

METHODS: PD-L1 expression was determined immunohistochemically (clone 28-8) in 61 paired samples of effusions and biopsies from patients with pleural MM, obtained at the time of diagnosis. Only cases with >100 tumor cells were included. Membranous staining in tumor cells was considered positive at ≥1%, >5%, >10%, and >50% cutoff levels.

RESULTS: Of 61 histologic samples, PD-L1 expression was found in 28 and 7 samples at ≥1% and >50% cutoffs, respectively; the corresponding figures for cytology were 21 and 5, respectively. The overall percentage agreement between histology and cytology was 69% and 84%, with a kappa (κ) of 0.36 and 0.08 at ≥1% and >50% cutoffs, respectively. The concordance between cytology and histology tended to be higher for epithelioid MM versus nonepithelioid MM at a ≥1% cutoff. PD-L1 positivity in biopsies, but not in effusions, correlated with the histologic subtype at a ≥1% cutoff.

CONCLUSIONS: A moderate concordance of PD-L1 expression between biopsies and effusions from pleural MM, especially for the epithelioid subtype, indicates biological differences between the 2 types of specimens. Cytology and histology may be complementary.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Cancer Cytopathology
volume
129
issue
6
pages
11 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:33493383
  • scopus:85099964741
ISSN
1934-6638
DOI
10.1002/cncy.22401
project
Improvement of diagnostic and prognostic cytopathology of lung cancer and malignant mesothelioma.
Biomarkers in mesothelioma and non-small cell lung cancer: Investigation of cytological specimens with correlation to histology
language
English
LU publication?
yes
additional info
© 2021 The Authors. Cancer Cytopathology published by Wiley Periodicals LLC on behalf of American Cancer Society.
id
cc8977e2-f49a-45fc-9fa3-003706e04dcf
date added to LUP
2021-02-01 13:08:34
date last changed
2024-06-13 06:41:31
@article{cc8977e2-f49a-45fc-9fa3-003706e04dcf,
  abstract     = {{<p>BACKGROUND: Malignant mesothelioma (MM) is a therapy-resistant tumor, often causing an effusion. Drugs targeting the programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathway have shown promising results, but assessment of PD-L1 expression to select patients for therapy has mainly been performed on histologic tissue samples. In a previous study, we showed that MM effusions are suitable for PD-L1 assessment with results comparable to those reported in histologic studies, but no studies have compared PD-L1 expression in histologic and cytologic samples.</p><p>METHODS: PD-L1 expression was determined immunohistochemically (clone 28-8) in 61 paired samples of effusions and biopsies from patients with pleural MM, obtained at the time of diagnosis. Only cases with &gt;100 tumor cells were included. Membranous staining in tumor cells was considered positive at ≥1%, &gt;5%, &gt;10%, and &gt;50% cutoff levels.</p><p>RESULTS: Of 61 histologic samples, PD-L1 expression was found in 28 and 7 samples at ≥1% and &gt;50% cutoffs, respectively; the corresponding figures for cytology were 21 and 5, respectively. The overall percentage agreement between histology and cytology was 69% and 84%, with a kappa (κ) of 0.36 and 0.08 at ≥1% and &gt;50% cutoffs, respectively. The concordance between cytology and histology tended to be higher for epithelioid MM versus nonepithelioid MM at a ≥1% cutoff. PD-L1 positivity in biopsies, but not in effusions, correlated with the histologic subtype at a ≥1% cutoff.</p><p>CONCLUSIONS: A moderate concordance of PD-L1 expression between biopsies and effusions from pleural MM, especially for the epithelioid subtype, indicates biological differences between the 2 types of specimens. Cytology and histology may be complementary.</p>}},
  author       = {{Mansour, Mohammed S I and Seidal, Tomas and Mager, Ulrich and Dobra, Katalin and Brunnström, Hans and Dejmek, Annika}},
  issn         = {{1934-6638}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  pages        = {{468--478}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Cancer Cytopathology}},
  title        = {{Higher concordance of PD-L1 expression between biopsies and effusions in epithelioid than in nonepithelioid pleural mesothelioma}},
  url          = {{http://dx.doi.org/10.1002/cncy.22401}},
  doi          = {{10.1002/cncy.22401}},
  volume       = {{129}},
  year         = {{2021}},
}