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. 2020 Jan 27;10(1):1243.
doi: 10.1038/s41598-019-57321-x.

Prognostic impact of PD-L1 expression in correlation with neutrophil-to-lymphocyte ratio in squamous cell carcinoma of the lung

Yuko Tashima #  1 , Taiji Kuwata #  1 , Kazue Yoneda  2 , Ayako Hirai  1 , Masataka Mori  1 , Masatoshi Kanayama  1 , Naoko Imanishi  1 , Koji Kuroda  1 , Yoshinobu Ichiki  1 , Fumihiro Tanaka  1
Affiliations

Prognostic impact of PD-L1 expression in correlation with neutrophil-to-lymphocyte ratio in squamous cell carcinoma of the lung

Yuko Tashima et al. Sci Rep. .

Abstract

The prognostic impact of tumoral programmed death-ligand 1 (PD-L1) expression in correlation with neutrophil-to-lymphocyte ratio (NLR) was retrospectively assessed in 83 patients with completely resected stage I squamous cell carcinoma of the lung, as PD-L1 is a potent regulator of cancer immunity and NLR is a potential surrogate of immune status. Forty-three patients (51.8%) had tumor with positive PD-L1 expression. There was no significant correlation between PD-L1 expression and NLR. PD-L1-positivity failed to provide a significant prognostic impact (overall survival [OS] rate at 5 years, 53.0% in PD-L1-positive patients versus 70.1% in PD-L1-negative patients; P = 0.117). Among NLR-low (<2.2) patients, however, PD-L1-positivity was significantly correlated with a poor prognosis (OS rate at 5 years, 46.1% versus 86.0%; P = 0.020). In contrast, among NLR-high (≥2.2) patients, PD-L1-positivity provided no prognostic impact (P = 0.680). When NLR status and tumoral PD-L1 status were combined, "NLR-low and PD-L1-negative" was a significant and independent factor to predict a favorable recurrence-free survival (hazard ratio, 0.237 [95% confidence interval, 0.083 to 0.674]; P = 0.007) and OS (hazard ratio, 0.260 [0.091 to 0.745]; P = 0.012). These results suggest the prognostic impact of tumoral PD-L1 expression might be influenced by the status of NLR.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Distribution of neutrophil-to-lymphocyte ratio (NLR) and tumor proportion score (TPS) for tumoral PD-L1 expression (left). Receiver operating characteristics (ROC) curves to examine diagnostic performance of NLR (right upper) and TPS (right lower) for prediction of death from any cause. AUC-ROC, area under ROC curve.
Figure 2
Figure 2
Recurrence-free survival (PFS) and overall survival (OS) curves according to neutrophil-to-lymphocyte ratio (NLR) and tumor proportion score (TPS) for tumoral PD-L1 expression status. The cut-off value for NLR and TPS were 2.2 and 1, respectively.
Figure 3
Figure 3
Recurrence-free survival (PFS) and overall survival (OS) curves according to tumor proportion score (TPS) for tumoral PD-L1 expression status among patients with low neutrophil-to-lymphocyte ratio (NLR, less than 2.2) or among high NLR (2.2 or higher) patients. The cut-off value for NLR and TPS were 2.2 and 1, respectively.
Figure 4
Figure 4
Recurrence-free survival (PFS) and overall survival (OS) curves according to tumor proportion score (TPS) for tumoral PD-L1 expression status in combination with status of neutrophil-to-lymphocyte ratio (NLR). The cut-off value for NLR and TPS were 2.2 and 1, respectively.
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