Abstract
Background: PD-L1 expression in tumor cells can predict the efficacy of PD-1/PD-L1 inhibitors and prognosis in patients. However, the correlation between the PD-L1 expression and the novel lung adenocarcinoma classification are obscure. Methods: 126 lung adenocarcinoma cases were reviewed in the Third Affiliated Hospital of Soochow University from Jan. to Dec. 2019. PD-L1 (DAKO 22C3) was used to test the PD-L1 expression in lung cancer tissue. Result: TPS was used to interpret the PD-L1 expression. The negative, low positive and high positive of PD-L1 were 72 cases (57.14%), 39 cases (30.95%) and 15 cases (11.90%). PD-L1 TPS in solid structure was significantly higher than that in acinar structure, lepidic structure and papillary structure (P<0.001, respectively). The results of c2 test showed the PD-L1 expression had the significant difference with gender (P = 0.005), age (P = 0.030), smoking history (P = 0.024), lymph node metastasis (P <0.001), TNM stage (P = 0.001), acinar structure (P = 0.003) and solid structure (P < 0.001). Multi-factor linear regression results suggested that solid structure, TNM stage and smoking history were associated with PD-L1 expression (P < 0.05). The solid structure showed more capability to PD-L1 expression (β = 0.428). Conclusion: PD-L1 expression was heterogeneity in lung adenocarcinoma. The solid structure, TNM stage and smoking history were correlation to up-regulation of PD-L1 expression, and solid structure was the most importance factor.