Relevance Between Programmed Death Ligand 1 and Radiologic Invasiveness in Pathologic Stage I Lung Adenocarcinoma Gouji Toyokawa, PhD, Kazuki Takada,

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Relevance Between Programmed Death Ligand 1 and Radiologic Invasiveness in Pathologic Stage I Lung Adenocarcinoma Gouji Toyokawa, PhD, Kazuki Takada, MD, Tatsuro Okamoto, PhD, Satoshi Kawanami, PhD, Yuka Kozuma, MD, Taichi Matsubara, MD, Naoki Haratake, MD, Shinkichi Takamori, MD, Takaki Akamine, MD, Masakazu Katsura, MD, Yuichi Yamada, MD, Fumihiro Shoji, PhD, Shingo Baba, PhD, Takeshi Kamitani, PhD, Yoshinao Oda, PhD, Hiroshi Honda, PhD, Yoshihiko Maehara, PhD The Annals of Thoracic Surgery Volume 103, Issue 6, Pages 1750-1757 (June 2017) DOI: 10.1016/j.athoracsur.2016.12.025 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Representative images of a patient with programmed death ligand 1 (PD-L1) expression: (A) radiologic invasive lung nodule with a consolidation/tumor (C/T) ratio of 0.85; (B) hematoxylin-eosin staining showing papillary predominant growth; and (C) immunopositivity for PD-L1 expression by immunohistochemistry. Representative images of a patient without PD-L1 expression: (D) radiologic noninvasive lung nodule with a C/T ratio of 0 (pure ground-glass opacity); (E) hematoxylin-eosin staining showing lepidic predominant growth; and (F) immunonegativity for PD-L1 expression by immunohistochemistry. Scale bar: 100 μm. The Annals of Thoracic Surgery 2017 103, 1750-1757DOI: (10.1016/j.athoracsur.2016.12.025) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Consolidation/tumor (C/T) ratio and maximum standardized uptake value (SUVmax) according to programmed death ligand 1 (PD-L1) expression and epidermal growth factor receptor (EGFR) status. (A) The C/T ratios and (B) SUVmax were significantly higher in patients with PD-L1 expression than patients without (p < 0.001 and p < 0.001, respectively). (C) The C/T ratios and (D) SUVmax were significantly lower in patients with mutated EGFR than wild-type EGFR (p < 0.001 and p = 0.037, respectively). The Annals of Thoracic Surgery 2017 103, 1750-1757DOI: (10.1016/j.athoracsur.2016.12.025) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Consolidation/tumor (C/T) ratio and maximum standardized uptake value (SUVmax) according to programmed death ligand 1 (PD-L1) in adenocarcinomas with a radiologic size of 2.0 cm or less. (A) The C/T ratio and (B) SUVmax were significantly higher in patients with PD-L1 expression than in patients without (p < 0.001 and p = 0.016, respectively). The Annals of Thoracic Surgery 2017 103, 1750-1757DOI: (10.1016/j.athoracsur.2016.12.025) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Kaplan-Meier curves according to programmed death ligand 1 (PD-L1) expression: (A) disease-free survival and (B) overall survival were significantly worse among patients with PD-L1 expression than patients without (p = 0.006 and p < 0.001, respectively). The Annals of Thoracic Surgery 2017 103, 1750-1757DOI: (10.1016/j.athoracsur.2016.12.025) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions