[上消化道 PD-L1 预测性标准化和质量保证检测。德文版]。

Pathologie (Heidelberg, Germany) Pub Date : 2024-02-01 Epub Date: 2024-01-03 DOI:10.1007/s00292-023-01215-3
G Baretton, F Lordick, T Gaiser, R Hofheinz, D Horst, S Lorenzen, M Möhler, C Röcken, P Schirmacher, M Stahl, P Thuss-Patience, K Tiemann
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引用次数: 0

摘要

由于免疫肿瘤治疗概念的不断增加,食管、胃食管交界处和胃癌领域的治疗决策和控制的复杂性也在不断增加。由于目前欧盟批准的 PD-1 抑制剂的治疗适应症通常与 PD-L1(程序性细胞死亡配体 1)的表达有关,因此病理学家对组织预测标记物的评估对治疗分层至关重要。尽管PD-L1表达状态的免疫组化分析是研究得最好的、与免疫肿瘤治疗相关的生物标记物之一,但由于上消化道癌的高度异质性,日常临床诊断工作在检测的实施、标准化和解释方面都面临着挑战。一个由德国专家组成的跨学科小组就日常病理和临床实践中的相关问题(涉及起始材料、有质量保证的检测和病理结果的解释)表明了立场,并为结构化报告提出了建议。
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[Standardized and quality-assured predictive PD-L1 testing in the upper gastrointestinal tract. German version].

As a result of the high approval dynamics and the growing number of immuno-oncological therapy concepts, the complexity of therapy decisions and control in the area of carcinomas of the esophagus, gastroesophageal junction and stomach is constantly increasing. Since the treatment indication for PD‑1 inhibitors that are currently approved in the European Union is often linked to the expression of PD-L1 (programmed cell death-ligand 1), the evaluation of tissue-based predictive markers by the pathologist is of crucial importance for treatment stratification. Even though the immunohistochemical analysis of the PD-L1 expression status is one of the best studied, therapy-relevant biomarkers for an immuno-oncological treatment, due to the high heterogeneity of carcinomas of the upper gastrointestinal tract, there are challenges in daily clinical diagnostic work with regard to implementation, standardization and interpretation of testing. An interdisciplinary group of experts from Germany has taken a position on relevant questions from daily pathological and clinical practice, which concern the starting material, quality-assured testing and the interpretation of pathological findings, and has developed recommendations for structured reporting.

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