Li Xiaoxian, Wetherilt Ceyda Sonmez, Krishnamurti Uma, Yang Jing, Ma Yamin, Styblo Toncred M, Meisel Jane L, Peng Limin, Siddiqui Momin T, Cohen Cynthia, Aneja Ritu
From the Department of Pathology and Laboratory Medicine,
Department of Biology, Georgia State University, Atlanta.
Am J Clin Pathol. 2016 Oct;146(4):496-502. doi: 10.1093/ajcp/aqw134.
Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer, and there is no approved targeted therapy. We studied the expression of programmed cell death protein 1 (PD-1) and its ligand (PD-L1) in TNBC.
Full-face sections from 136 TNBC cases without neoadjuvant therapy between 2004 and 2013 were stained and evaluated for immune cell PD-1 staining and stromal or tumoral PD-L1 staining using the H-score (staining percentage × intensity). Nottingham histologic grade, lymphovascular invasion (LVI), mitotic count, and tumor-infiltrating lymphocytes (TILs) were evaluated. Tumor size, lymph node status, Ki-67 score, metastasis, overall survival (OS), and disease-free survival (DFS) were retrieved from medical records.
Of the 136 TNBC cases, 69 (51%) had any PD-L1 staining and 35 (26%) had PD-L1 staining with an H-score of 5 or more; 117 (86%) had any PD-1 staining and 68 (50%) had PD-1 staining with an H-score of 5 or more. Tumor size and LVI were significantly associated with worse OS and DFS, and TILs and LVI were significantly associated with metastasis in univariate analysis. Stromal PD-L1 expression was significantly associated with better DFS in multivariate analysis. PD-1 expression was not associated with DFS, OS, or metastasis.
PD-L1 expression is seen in a high proportion of TNBCs and associated with better DFS.
三阴性乳腺癌（TNBC）是一种侵袭性乳腺癌亚型，目前尚无获批的靶向治疗方法。我们研究了程序性细胞死亡蛋白1（PD-1）及其配体（PD-L1）在TNBC中的表达情况。
对2004年至2013年间136例未经新辅助治疗的TNBC病例的全脸切片进行染色，并使用H评分（染色百分比×强度）评估免疫细胞PD-1染色以及基质或肿瘤PD-L1染色情况。评估诺丁汉组织学分级、淋巴管浸润（LVI）、有丝分裂计数和肿瘤浸润淋巴细胞（TILs）。从病历中获取肿瘤大小、淋巴结状态、Ki-67评分、转移情况、总生存期（OS）和无病生存期（DFS）。
在136例TNBC病例中，69例（51%）有任何PD-L1染色，35例（26%）的PD-L1染色H评分为5或更高；117例（86%）有任何PD-1染色，68例（50%）的PD-1染色H评分为5或更高。在单因素分析中，肿瘤大小和LVI与较差的OS和DFS显著相关，TILs和LVI与转移显著相关。在多因素分析中，基质PD-L1表达与较好的DFS显著相关。PD-1表达与DFS、OS或转移无关。
在高比例的TNBC中可见PD-L1表达，且与较好的DFS相关。
