Although these findings align with those of clinical practice, and previous studies have shown high consistency between puncture and surgical samples,46,47 spatial heterogeneity in NSCLC may introduce sampling bias, particularly for tumors with low PD-L1 expression.48 Future studies incorporating multiregional biopsy or liquid biopsy-based PD-L1 profiling are warranted to mitigate this limitation. The gene discussed is CD274; the disease is non-small cell lung carcinoma.