Gastrointestinal tract metastasis of lung cancer: The PD‐L1 expression and correlated clinicopathological variables

The gastrointestinal tract is a rare site for metastatic lung cancer. Programmed cell death‐ligand 1 (PD‐L1) expression in lung cancer is a biomarker for the response to anti‐PD‐1/PD‐L1 therapy. We investigated clinicopathological features and PD‐L1 expression in 25 gastrointestinal metastatic tumor...

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Bibliographic Details
Published in:Pathology international 2021-01, Vol.71 (1), p.33-41
Main Authors: Ishikawa, Eri, Nakaguro, Masato, Nakamura, Masanao, Yamamura, Takeshi, Sawada, Tsunaki, Mizutani, Yasuyuki, Maeda, Keiko, Furukawa, Kazuhiro, Shimoyama, Yoshie, Kawashima, Hiroki, Fujishiro, Mitsuhiro
Format: Article
Language:English
Subjects:
Adenocarcinoma
Apoptosis
Biomarkers
Cell death
gastrointestinal metastasis
Gastrointestinal system
Gastrointestinal tract
Immune checkpoint inhibitors
Immune system
Lung cancer
Metastases
Metastasis
PD-L1 protein
PD‐L1
small bowel
Small intestine
small‐bowel metastasis
Tumor cells
Tumors
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Summary:The gastrointestinal tract is a rare site for metastatic lung cancer. Programmed cell death‐ligand 1 (PD‐L1) expression in lung cancer is a biomarker for the response to anti‐PD‐1/PD‐L1 therapy. We investigated clinicopathological features and PD‐L1 expression in 25 gastrointestinal metastatic tumors from the lung and primary adenocarcinoma of the small bowel. The small bowel was the most common site (16/25; 64%) of gastrointestinal tract lung cancer metastasis. A total of 19 (76%) of the gastrointestinal metastasis showed PD‐L1 expression in ≥5% of tumor cells, with 14 (56%) showing high expression levels (≥50%). In contrast, 21 (84%) expressed PD‐L1 in ≥5% immune cells, including 4 (16%) showing a high expression levels (≥50%). The PD‐L1 expression on tumor cells and immune cells in primary lung cancer and corresponding gastrointestinal metastasis was concordant in 13 (68%) and 11 (58%) of the 19 paired cases, respectively. Small‐bowel metastasis of lung cancer was characterized by a higher incidence of perforation (31% vs. 0%), ulcerated mass (83% vs. 60%), and neoplastic PD‐L1 expression (75% vs. 0%) compared to primary small‐bowel adenocarcinoma. Gastrointestinal metastasis from lung cancer might be a potential target for immune checkpoint inhibitor therapy, given its high expression of PD‐L1.
ISSN:1320-5463
1440-1827
DOI:10.1111/pin.13048