在晚期非小细胞肺癌（NSCLC）中，肿瘤比例分数（TPS）通常用于预测免疫检查点抑制剂（ICIs）的疗效。然而，在其他癌症类型中，综合阳性分数（CPS）被用于评估肿瘤及其周围免疫细胞上程序性死亡配体1（PD-L1）的表达。我们研究了CPS与TPS在晚期NSCLC中的预测价值。在2015年至2021年期间，我们进行了一项单中心、回顾性研究，纳入了接受ICI单药治疗的晚期NSCLC患者。我们在基线肿瘤活检样本上染色了血红素和噻唑蓝，并对PD-L1进行了TPS和CPS评分。TPS和CPS的阳性定义为1%或更高的分数。我们评估了TPS和CPS评分对无进展生存和总生存（OS）的影响。在纳入的187例患者中，TPS阳性发生在112例患者（59.9%），CPS阳性发生在135例患者（72.2%）。TPS阳性患者和TPS阴性患者的OS没有显著差异（p = 0.20）。然而，CPS阳性患者的OS要比CPS阴性患者长（p = 0.006）。与TPS阴性/CPS阴性病例相比，TPS阴性/CPS阳性和TPS阳性/CPS阳性病例的OS更好（分别为p = 0.018和p = 0.015），而在TPS阴性/CPS阳性和TPS阳性/CPS阳性病例之间没有明显的OS差异。这项回顾性的实际人群研究发现，在接受ICI单药治疗的晚期NSCLC患者中，CPS比TPS更好地区分了OS。值得注意的是，这是由TPS阴性/CPS阳性亚组的表现推动的，表明CPS可能是ICI疗效的更好预测生物标志物。© 2023 The Authors.

In advanced-stage NSCLC, tumor proportion score (TPS) is typically used to predict the efficacy of immune checkpoint inhibitors (ICIs). Nevertheless, in other cancer types, the combined positive score (CPS), which covers programmed death-ligand 1 (PD-L1) expression on both tumor and surrounding immune cells, is used. We investigated the predictive value of CPS in comparison to TPS in advanced NSCLC.A monocenter, retrospective study was performed in patients with advanced NSCLC treated with ICI monotherapy between 2015 and 2021. Hematoxylin and eosin and PD-L1 were stained on baseline tumor biopsy samples to score PD-L1 by both TPS and CPS. Positivity for TPS and CPS was defined as a score of 1% or above. Progression-free survival and overall survival (OS) were assessed for TPS and CPS scores.Among the 187 included patients, PD-L1 positivity was found in 112 patients (59.9%) by TPS and 135 patients (72.2%) by CPS. There was no significant difference in OS between TPS- and TPS+ patients (p = 0.20). Nevertheless, CPS+ patients did have a longer OS than CPS- patients (p = 0.006). OS was superior in both TPS-/CPS+ and TPS+/CPS+ as compared with TPS-/CPS- cases (p = 0.018 and p = 0.015, respectively), whereas no considerable differences in OS were found between TPS-/CPS+ and TPS+/CPS+ cases.This retrospective real-world population study revealed that CPS differentiated OS better than TPS in patients with advanced NSCLC with ICI monotherapy. Remarkably, this was driven by the performance of the TPS-/CPS+ subgroup, indicating that CPS may be a better predictive biomarker for ICI efficacy.© 2023 The Authors.