| Abstract | Cilj: Cilj ovog presiječnog istraživanja je istražiti povezanost između izraženost PD-L1 s postojanjem aktivirajuće mutacije za EGFR nakon prilagodbe za dob, spol i stadij. -----
Metode: U ovo unicentrično, ugniježdeno, presiječno istraživanje je uključeno 525 bolesnika kojima se dijagnosticirao nesitnostanični karcinom pluća u razdoblju od 2018. do 2020. godine. Zavisna varijabla je bila ekspresija PD-L1 koja se klasificirala u tri skupine ovisno o patohistološkom nalazu: 1) negativna ekspresija kao manje od 1% PD-L1 pozitivnih stanica u tkivu tumora, 2) niska, određena kao 1-49% te 3) visoka, određena kao 50-100% PD-L1 pozitivnih stanica. Nezavisna varijabla je postojanje mutacije za EGFR. Podatci su skupljeni iz bolničkog informacijskog sustava te je napravljena statistička analiza. -----
Rezultati: Medijan (IKR) dobi sudionika iznosio je 65 (60-70) godina, ukupni raspon dobi bio je od 31 do 84 godine. Pozitivan EGFR status zabilježen je kod 64 (12,2%) bolesnika, a visoka izraženost PD-L1 kod 140 (26,7%). Povezanost izraženosti PD-L1 s EGFR statusom bila je statistički značajna nakon prilagodbe za dob, spol i stadij bolesti (Multivarijabilina ordinalna regresija; OI = 0,55 (95% IP 0,32; 0,95); p = 0,031; SLO < 5%) Nakon prilagodbe za spomenute čimbenike, procijenjena vjerojatnost da će bolesnik s pozitivnim EGFR statusom imati visoku izraženost PD-L1 iznosila je 0,17 (95% IP 0,09; 0,24), za razliku od bolesnika s negativnim EGFR statusom kod kojih je procijenjena vjerojatnost za visoki PD-L1 iznosila 0,27 (0,23; 0,31). -----
Zaključak: Izraženost PD-L1 u nesitnostaničnom karcinomu pluća je statistički značajno povezana s EGFR statusom i nakon prilagodbe za dob, spol i stadij. Povezanost je inverzna, sudionici s mutacijom za EGFR imaju 50% manje šanse da imaju visoku izraženost PD-L1. |
| Abstract (english) | Goals: The aim of this cross-sectional study was to investigate the existence of a correlation between the expression of PD-L1 and the mutation for the EGFR in non-small cell lung cancer. -----
Methods: This nested, cross-sectional, unicentric research included 525 patients that were diagnosed with non-small cell lung cancer between 2018 and 2020. The dependent variable of the study was the expression of PD-L1. The expression of PD-L1 was classified into three subgroups depending on the pathohistological finding. Negative expression of PD-L1 was defined as less than 1% of PD-L1 positive cells in the tumor tissue, low expression of PD-L1 was defined as the finding of between 1-49% of PD-L1 positive cells in the tumor tissue and high expression of PD-L1 was defined as the existence of more than 50% of PD-L1 positive cells in the tumor tissue. The independent variable was the existence of an EGFR mutation. The data was collected from the hospital information system and analyzed by a clinical statistician. -----
Results: The median age of participants was 65 (60-70) years, with the age range being 31 to 84 years. 64 (12,2%) participants were positive for the EGFR mutation. 140 participants had a high expression of PD-L1. The correlation between PD-L1 expression and the existence of an EGFR mutation was statistically significant after correcting for age, sex and stage of the disease (multivariable ordinal regression; OI = 0,55 (95% IP 0,32; 0,95); p = 0,031; SLO < 5%) After correcting for the aforementioned factors the estimated probability that a patient with an EGFR positive finding will have a high expression of PD-L1 was 0,17 (95% IP 0,09; 0,24). A patient with an EGFR negative finding was estimated to have a 0,27 (0,23; 0,31) probability of having a high expression of PD-L1. -----
Conclusion: The correlation between the expression of PD-L1 and the existence of the EGFR mutation in non-small cell lung cancer is statistically significant even after adjusting for the presence of confounding factors. The correlation is negative meaning that the EGFR positive patients are 50% less likely to have a high expression of PD-L1. |
