https://doi.org/10.4081/monaldi.2025.3288
Programmed cell death-ligand 1 expression and CD8 positive tumor-infiltrating lymphocyte density in non-small cell lung carcinoma and its association with histopathological grading
Submitted: December 2, 2024
Accepted: December 6, 2024
Published: February 21, 2025
Accepted: December 6, 2024
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Non-small cell lung carcinoma (NSCLC), comprising 85% of lung cancers, remains a leading cause of cancer mortality despite advances in treatment. Immunotherapy, particularly immune checkpoint inhibitors targeting the PD-1/PD-L1 axis, has revolutionized therapy, though outcomes vary. This study aimed to explore the association between PD-L1 expression, CD8 tumor-infiltrating lymphocyte (TIL) density, and histopathological grading in NSCLC. Our retrospective, single-centered cohort comprised 64 biopsy samples of NSCLC. PD-L1 and CD8 TILs density was assessed through immunohistochemistry. We also classified the tumors into four groups based on the PD-L1 and CD8-positive TIL statuses and evaluated their association with clinicopathological parameters. Male subjects were the predominant population in the study group (86%), with a mean age of 60 years. Most of the cases were smokers/ex-smokers (70.3%). Among 64 cases, PD-L1 positivity was observed in 62.5%, correlating with poorly differentiated tumors (grade 3) (p=0.03), suggesting its association with poor prognosis. Among PD-L1 positive cases, 55% had high expression and 45% had low expression. CD8 TIL density was low in 62.5% of cases and showed no significant correlation with clinical variables. Combined analysis revealed that 42.19% of cases were PD-L1+/CD8 low, a phenotype indicative of immune evasion and aggressive tumor behavior. Overall, our results emphasize that while PD-L1 immunohistochemistry remains a critical tool for identifying candidates for immunotherapy, it is not a standalone predictor of treatment response. Integrating CD8 TIL density provides additional prognostic information, potentially guiding more personalized treatment strategies.
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Ethics Approval
Ethical clearance taken from the Institutional Ethics Committee, VMMC, and Safdarjung Hospital, New Delhi, with serial no. IEC/VMMC/SJH/Thesis/2023-03/CC-241 dated 27th March 2023.How to Cite
Sureka, Niti, Sheetal Arora, Pranav Ish, and Geetika Khanna. 2025. “Programmed Cell Death-Ligand 1 Expression and CD8 Positive Tumor-Infiltrating Lymphocyte Density in Non-Small Cell Lung Carcinoma and Its Association With Histopathological Grading”. Monaldi Archives for Chest Disease, February. https://doi.org/10.4081/monaldi.2025.3288.
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