# Evaluating the Relationship Between Programmed Death Ligand-1 (Clone: 22C3), Anaplastic Lymphoma Kinase (D5F3), and C-ros Oncogene 1 (OT11A1) Expression in Lung Adenocarcinoma

## TL;DR

This study examines how PD-L1, ALK, and ROS1 expression relate in lung adenocarcinoma, finding that PD-L1 is linked to disease stage but not to ALK or ROS1.

## Contribution

The study provides new insights into the independent expression patterns of PD-L1, ALK, and ROS1 in lung adenocarcinoma.

## Key findings

- PD-L1 expression was significantly associated with clinical stage (p = 0.048).
- No significant associations were found between clinical stage and ALK or ROS1 positivity.
- PD-L1 positivity did not correlate significantly with ALK or ROS1 positivity.

## Abstract

Objective

This study investigates the relationship between programmed death ligand-1 (PD-L1), anaplastic lymphoma kinase (ALK), and c-ros oncogene 1 (ROS1) expression in lung adenocarcinoma (ADC).

Methods

Sixty-two cases were analyzed for ALK, ROS1, and PD-L1 expression using immunohistochemistry. Statistical evaluations were performed using chi-square and Fisher’s exact tests.

Results

Among the 62 cases, 24 (39%) were identified as PD-L1 positive, while four (6.45%) and three (4.84%) demonstrated ALK and ROS1 positivity, respectively, highlighting the molecular heterogeneity of lung adenocarcinoma. A significant association was observed between PD-L1 expression and the clinical stage of the disease (p = 0.048, df = 5, χ² = 11.12), suggesting the potential of PD-L1 as a biomarker for tumor progression. Conversely, no significant associations were found between clinical stage and ROS1 (p = 0.61, df = 5, χ² = 3.62) or ALK positivity (p = 0.13, df = 5, χ² = 8.58), indicating limited relevance of these genetic alterations to disease staging. Correlations between PD-L1 positivity and ALK or ROS1 positivity were also not definitive; the odds ratios were approximately 33.1 (95% confidence interval (CI): 2.1-518.5) for ALK (p ≈ 0.058) and 27.1 (95% CI: 1.7-424) for ROS1 (p ≈ 0.058). Only three cases exhibited copositivity for both ALK and ROS1, with an odds ratio of about 1.17 (95% CI: 0.20-6.58) and a p-value of approximately 0.95, indicating no significant association.

Conclusion

The expression of PD-L1 is independent of ALK and ROS1 alterations in lung adenocarcinoma, suggesting that these biomarkers do not significantly correlate with one another.