Comparative Study of PD-L1 Expression in Different Sites of Non-small Cell Lung Cancer / 中国肺癌杂志

BACKGROUND@#The expression of programmed cell death ligand 1 (PD-L1) as a biomarker for immunotherapy in non-small cell lung cancer (NSCLC) is routinely detected in clinical pathology department. However, the spatial heterogeneity of PD-L1 expression in intrapulmonary tumors and extrapulmonary metastases is still a challenge for the clinical testing. This study aims to explore the differences of PD-L1 expression in test samples obtaining from different sites of NSCLC. This study may contribute to the detection strategy of PD-L1 in patients with advanced lung cancer.@*METHODS@#One hundred and thirty-one cases of consecutively detected PD-L1 (22c3 assay, Dako) staining in metastatic NSCLC and 972 cases of non-paired intrapulmonary NSCLC were collected. The discrepancies of tumor proportion score (TPS) of PD-L1 expression in intrapulmonary samples and extrapulmonary metastatic samples of different sites were compared.@*RESULTS@#The positive expression rate of PD-L1 in extrapulmonary metastatic NSCLC (TPS ≥ 1%) was 61.83%, and the TPS was significantly higher than that in intrapulmonary tumors (P=0.03). The PD-L1 scores of the specimens obtained from different sites were significantly different (P=0.007). The positive rates of PD-L1 in liver and adrenal metastases were 85.71% and 77.78% respectively, and their TPS were significantly higher than that of the intrapulmonary samples (P<0.05). The positive rates of PD-L1 in lymph node, bone, brain, soft tissue, and pleural metastases was 40.00%-66.67%, with no significant differences compared to intrapulmonary tumors. The analysis of histological subtype and sample type showed that the PD-L1 score of extrapulmonary samples of adenocarcinoma subtype or surgical specimen was significantly higher than that of intrapulmonary tumors. The analysis of clinicopathological parameters showed that the PD-L1 positive expression or high expression were significantly correlated with male patients, smoking history, and epidermal growth factor receptor (EGFR) wild type.@*CONCLUSIONS@#The expression of PD-L1 in metastatic NSCLC is generally higher than that in intrapulmonary tumor, and the positive rate of PD-L1 expression was discrepant in different sites of specimen. The differences of PD-L1 score between extrapulmonary metastatic samples and intrapulmonary samples may be associated with different metastatic sites, histological subtype, and specimen type.

Intermediary role of experiential avoidance in neurosis and posttraumatic stress response in firefighters / 中国职业医学

OBJECTIVE: To explore the mediating effect of experiential avoidance on neurosis and posttraumatic stress response in firefighters. METHODS: A cluster random sampling method was used to select 275 male firefighters from 26 Fire Alarm squadrons in a province of China.The Neuroticism subscale of Eysenck Personality Questionnaire Short Scale, the Acceptance and Action Questionnaire-Second Edition, and the Impact of Event Scale were used to investigate the relationship of neurosis, experiential avoidance and posttraumatic stress response. RESULTS: The median score of neurosis, experiential avoidance and posttraumatic stress response was 5, 21 and 15, respectively. Both neurosis and experiential avoidance were positively correlated with posttraumatic stress syndromes(Spearman correlation coefficient were 0.45 and 0.45, P<0.01). The total effect of neurosis on posttraumatic stress response in firefighters was 0.57. The intermediary role of experiential avoidance on neurosis and posttraumatic stress response was 0.19, accounting for 33.33% of the total effect. CONCLUSION: Experiential avoidance plays a partial positive mediating role between neurosis and posttraumatic stress response in firefighters.

Study on the intermediary factors on the influence of personality traits in post-traumatic stress response of armed police soldiers / 中国职业医学

OBJECTIVE: To explore the mediating role of social support,psychological resilience and rumination between personality traits and post-traumatic stress response,and discover methods for controlling and intervening post-traumatic stress response in armed police soldiers. METHODS: By judgment sampling method,895 armed police soldiers were selected and investigated by simple version of Eysenck Personality Questionnaire,Traumatic Event Scale of Essen Trauma Inventory,Perceived Social Support Scale,Rumination Reaction Scale,Resilience Scale and Impact of Event ScaleRevised. RESULTS: There were 22. 46%( 201/895) of armed police soldiers who had experienced traumatic events. The scores of post-traumatic stress response were( 34. 6 ± 13. 3). The soldiers with light,medium and heavy levels of posttraumatic stress response were 33. 33%,45. 77% and 20. 90%,respectively. The psychoticism and neuroticism dimension in personality traits of soldiers in trauma group were negatively correlated with social support and psychological resilience( P < 0. 01),and positively correlated with rumination and the level of post-traumatic stress response( P < 0. 01). The extraversion dimension in personality traits was positively correlated with social support and psychological resilience( P <0. 01) and negatively correlated with rumination and the level of post-traumatic stress reactions( P < 0. 05). The personality traits had direct effect on the level of post-traumatic stress response( P < 0. 01),but there was no direct effect after adding mediators( P > 0. 05). Through social support,rumination and psychological resilience,personality traits could produce multiple mediating effects on the level of post-traumatic stress response. The social support and rumination showed mediating effect that accounting for 86. 61% of the total mediating effect. CONCLUSION: The social support,psychological resilience and rumination had mediating effect in personality traits and level of post-traumatic stress response.The social support and rumination are two key factors of the intermediate path,which is the main point of psychological rescue and intervention for the armed police soldiers.