IHC Marker- PD-L1 Test: Booking, Price, and Results
About IHC Marker- PD-L1 Test
| Field | Value |
|---|---|
| Also Known As | PDL-1 IHC Test, Programmed Death-Ligand 1 Test, PDL1 Marker Test, PD-L1 by Immunohistochemistry Test |
| Sample Type | Tumour tissue biopsy (formalin-fixed, paraffin-embedded FFPE tissue block) |
| Fasting Required | No fasting required |
| Report Time | 7 days |
| Recommended For | Males and females of all ages diagnosed with specific cancers being considered for immunotherapy |
| Price | Starting at ₹17,000 |
What Is an IHC Marker- PD-L1 Test?
The IHC marker- PD-L1 test measures the level of a protein called PD-L1 (programmed death-ligand 1) in tumour tissue. PD-L1 is a protein that can shield cancer cells from the body's immune system, and knowing how much of it is present helps doctors decide whether a patient may benefit from immunotherapy. The test is performed on a tumour tissue sample using a laboratory method called immunohistochemistry (IHC), which uses special antibodies to identify specific proteins in tissue. It is also known as the PDL-1 IHC test, programmed death-ligand 1 test, PDL1 marker test, or PD-L1 by immunohistochemistry test.
What Does an IHC Marker- PD-L1 Test Measure?
This test analyses a single marker in tumour tissue. The result shows how strongly PD-L1 protein is expressed across the tumour cells examined.
PD-L1 protein expression is reported using two scoring methods:
| Score | What It Indicates |
|---|---|
| Tumour Proportion Score (TPS) | The percentage of viable tumour cells that show PD-L1 staining. This scoring method is commonly used for cancers such as non-small cell lung cancer. |
| Combined Positive Score (CPS) | A broader score that counts PD-L1 expression in tumour cells as well as in nearby immune cells, specifically lymphocytes and macrophages. This method is used for several other cancer types. |
The scoring method applied depends on your cancer type and the specific antibody clone used in the test.
Why Is an IHC Marker- PD-L1 Test Done?
This test is requested by oncologists after a cancer diagnosis to guide treatment decisions, particularly around immunotherapy.
Common Symptoms That May Require This Test
A doctor may order this test after a cancer diagnosis has already been made. The symptoms listed below are those that often lead to initial investigations and, eventually, to this test:
- Unexplained weight loss
- Persistent fatigue that does not improve with rest
- Persistent cough or difficulty breathing
- A palpable lump or mass in the body
- Blood in urine or stool
- Unusual changes in the skin
- Difficulty swallowing or persistent indigestion
Conditions This Test Can Help Detect
The IHC marker- PD-L1 test does not detect a condition on its own. Instead, it identifies patients most likely to respond to a group of medicines called immune checkpoint inhibitors. The relevant cancer types include:
- Non-small cell lung cancer (NSCLC)
- Cervical cancer
- Oesophageal cancer
- Gastric (stomach) cancer
- Head and neck squamous cell carcinoma
- Triple-negative breast cancer
- Urothelial carcinoma
In cancers where PD-L1 expression is high, immune checkpoint inhibitors can release the immune system's ability to recognise and attack cancer cells.
How to Prepare and What to Expect
No special preparation is needed before the IHC marker- PD-L1 test procedure. The key steps involve providing a tissue sample, which your doctor will arrange.
Do You Need to Fast?
No, fasting is not required for this test. There are no dietary restrictions before sample collection. Always follow specific instructions provided by your doctor.
Practical Tips Before Your Test
Keep the following points in mind before submitting your sample:
- Bring a detailed clinical history including your symptoms, previous test results, and relevant radiological reports, as this is required for the test.
- Carry your original histopathology report from your prior biopsy or surgery, if available.
- Inform your oncologist if you have already received chemotherapy or radiation therapy, as prior treatment can affect PD-L1 expression.
Step-by-Step Procedure
- Your oncologist or surgeon obtains a tumour tissue sample. If a tumour has already been surgically removed, a portion of that sample is used. If surgery has not taken place, a biopsy is performed.
- The biopsy may be done using a fine needle, a core needle, or a small surgical procedure, depending on the tumour's location and size.
- The collected tissue is placed immediately into a formalin solution, which preserves it. The sample remains in this solution for approximately 24 to 48 hours.
- The preserved tissue is then embedded in paraffin wax to create what is called an FFPE (formalin-fixed paraffin-embedded) tissue block. This block is what the laboratory uses for analysis.
- In the laboratory, IHC techniques are applied to thin slices of the block. Special antibodies bind to PD-L1 protein in the tissue, making it visible under a microscope.
- A trained pathologist analyses the stained tissue and reports the percentage of cells expressing PD-L1, along with the TPS or CPS score appropriate for your cancer type.
Factors That Can Affect Accuracy
Several factors may influence the reliability of results:
- A sample with fewer than 100 viable tumour cells may not be adequate for evaluation
- Prolonged storage or poor preservation of the tissue block
- Variation in PD-L1 expression across different areas of the same tumour
- The specific antibody clone used in the test
- Prior chemotherapy or radiation therapy, which may increase PD-L1 levels in the tissue
- Samples taken from a single site may not reflect PD-L1 status across the whole tumour
Understanding Your IHC Marker- PD-L1 Test Results
Results from the IHC marker- PD-L1 test are interpreted by a pathologist and reviewed by your oncologist in the context of your cancer type, stage, and overall health. The table below shows the general reference ranges:
| Score Type | Result | Interpretation |
|---|---|---|
| Tumour Proportion Score (TPS) | Less than 1% | Negative or low expression |
| Tumour Proportion Score (TPS) | 1% to less than 50% | Low to moderate expression |
| Tumour Proportion Score (TPS) | 50% or more | High expression |
| Combined Positive Score (CPS) | Less than 1 | Negative |
| Combined Positive Score (CPS) | 1 or more | Positive expression |
| Combined Positive Score (CPS) | 10 or more | Higher expression |
Disclaimer: These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, cancer type, stage, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
PD-L1 expression can vary significantly depending on several circumstances:
- PD-L1 levels may differ between the primary tumour and metastatic sites in the same patient. A sample taken from one location may not reflect expression across the entire cancer.
- Prior chemotherapy or radiation therapy may increase PD-L1 expression in the tissue, which can affect how results are interpreted.
- Samples with very few tumour cells carry a higher risk of a false-negative result, meaning PD-L1 may appear absent when it is actually present.
How to Maintain Healthy Levels
PD-L1 is a cancer biomarker, not a marker with lifestyle-modifiable levels. General tips to support your health during cancer care include:
- Follow your oncologist's guidance on nutrition and physical activity during treatment.
- Stay adequately hydrated and rest as recommended by your care team.
- Maintain regular follow-up appointments so your doctor can monitor your overall response to treatment.
Lupin Diagnostics IHC Marker- PD-L1 Test Price
The IHC marker- PD-L1 test cost at Lupin Diagnostics starts at ₹17,000. This test requires a visit to a hospital; home collection is not available for tissue-based tests of this type. The table below shows indicative prices:
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 17000 |
| CHENNAI | 17000 |
| HYDERABAD | 17000 |
| KOLKATA | 17000 |
| NAVI MUMBAI | 17000 |
| PUNE | 17000 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time to submit your FFPE tissue block or for sample collection as directed.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
The IHC marker- PD-L1 test helps oncologists determine whether a patient with certain cancers is likely to respond to a type of treatment called immunotherapy, specifically immune checkpoint inhibitors. It does not diagnose cancer on its own. Instead, it guides treatment selection after a cancer diagnosis has already been made.
If you already had a biopsy to diagnose your cancer, the same preserved tissue block is often used. If a fresh sample is needed, your doctor will arrange a biopsy using a fine needle, core needle, or a minor surgical procedure, depending on the tumour's location.
TPS (tumour proportion score) measures the percentage of tumour cells showing PD-L1 expression. CPS (combined positive score) includes PD-L1 expression in both tumour cells and nearby immune cells. Your pathologist will use whichever scoring method applies to your specific cancer type.
No. The IHC marker- PD-L1 test home collection is not available because the test requires a tumour tissue biopsy obtained through a medical procedure at a hospital or clinic. You will need to visit a Lupin Diagnostics centre or submit your existing FFPE tissue block through your doctor.
Not necessarily. While a high PD-L1 score generally suggests a better response to immune checkpoint inhibitors, some patients with low or negative scores have also benefited from immunotherapy. Your doctor will consider the full clinical picture, including cancer type, stage, and other biomarkers, before making a treatment decision.
At Lupin Diagnostics, the report is typically ready within 7 days. The test results are delivered directly via email or WhatsApp once they are ready.
IHC Marker- PD-L1 Test: Booking, Price, and Results
