Chen Miao-Fen, Chen Ping-Tsung, Chen Wen-Cheng, Lu Ming-Shian, Lin Paul-Yang, Lee Kuan Der
Department of Radiation Oncology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan.
College of Medicine, Chang Gung University, Chiayi, Taiwan.
Oncotarget. 2016 Feb 16;7(7):7913-24. doi: 10.18632/oncotarget.6861.
The aim of this study was to assess the significance of programmed cell death 1 ligand 1 (PD-L1) in esophageal squamous cell carcinoma (ESCC) and its association with IL-6 and radiation response. Weretrospectively enrolled 162 patients with ESCC, and examined the correlation between PD-L1 levels and clinical outcomes in esophageal cancer patients. Furthermore, the human esophageal SCC cell line CE81T and TE2 were selected for cellular experiments to investigate the role of PD-L1 in T cell functions and radiation response. Here we demonstrated that PD-L1 expression was significantly higher in esophageal cancer specimens than in non-malignant epithelium. In clinical outcome analysis, this staining of PD-L1 was positively linked to the clinical T4 stage (p=0.004), development of LN metastasis (p=0.012) and higher loco-regional failure rate (p=0.0001). In addition, the frequency of PD-L1 immunoreactivity was significantly higher in IL-6-positive esophageal cancer specimens. When IL-6 signaling was inhibited in vitro, the level of PD-L1 is significantly down-regulated. PD-L1 is a significant predictor for poor treatment response and shorter survival.As demonstrated through in vitro experiments, Irradiation increased PD-L1 expression in human esophageal cancer cells. The inhibition of T cell functions including proliferation and cytotoxicity against tumor cells might be the mechanisms responsible to the role of PD-L1 in radiation response. In conclusion, PD-L1 is important in determining the radiation response and could predict the prognosis of patients with esophageal SCC. Therefore, we suggest inhibition of PD-L1 as a potential strategy for the treatment of esophageal SCC.
本研究旨在评估程序性细胞死亡1配体1(PD-L1)在食管鳞状细胞癌(ESCC)中的意义及其与白细胞介素-6(IL-6)和放射反应的关联。我们回顾性纳入了162例ESCC患者,检测了食管癌患者中PD-L1水平与临床结局之间的相关性。此外,选用人食管鳞癌细胞系CE81T和TE2进行细胞实验,以研究PD-L1在T细胞功能和放射反应中的作用。我们在此证明,食管癌标本中PD-L1表达明显高于非恶性上皮。在临床结局分析中,PD-L1的这种染色与临床T4期(p=0.004)、淋巴结转移的发生(p=0.012)以及较高的局部区域失败率(p=0.0001)呈正相关。此外,IL-6阳性食管癌标本中PD-L1免疫反应性的频率明显更高。当在体外抑制IL-6信号传导时,PD-L1水平明显下调。PD-L1是治疗反应不佳和生存期较短的重要预测指标。体外实验表明,照射可增加人食管癌细胞中PD-L1的表达。抑制包括增殖和对肿瘤细胞的细胞毒性在内的T细胞功能可能是PD-L1在放射反应中发挥作用的机制。总之,PD-L1在确定放射反应中很重要,并且可以预测食管鳞癌患者的预后。因此,我们建议抑制PD-L1作为治疗食管鳞癌的潜在策略。