Zhang Wencheng, Pang Qingsong, Zhang Xiaodong, Yan Cihui, Wang Qifeng, Yang Jinsong, Yu Shufei, Liu Xiao, Pan Yi, Yuan Zhiyong, Wang Ping, Xiao Zefen
Department of Radiation Oncology, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Cancer Sci. 2017 Apr;108(4):590-597. doi: 10.1111/cas.13197. Epub 2017 Apr 25.
Programmed death-ligand 1 (PD-L1) expression either indicates immune inhibitory status or concurrent immune response. Although the relationship between PD-L1 and clinical outcomes has been studied widely in recent years, its role in prognosis of esophageal squamous cell carcinoma (ESCC) remains unclear. Here, we assessed the significance of PD-L1 in ESCC and its association with epidermal growth factor receptor (EGFR) and radiation response. We found that PD-L1 was present both on the surface of tumor cells and tumor-infiltrating immune cells. Patients with tumor-infiltrating immune cell PD-L1 expression had better survival. PD-L1 expression on immune cells was an independent prognostic factor for patients with ESCC. PD-L1 expression either on tumor-infiltrating immune cells or tumor cells was negatively associated with EGFR expression. EGFR/PD-L1 pairs could separate the survival between EGFR low/PD-L1 positive and EGFR high/PD-L1 negative groups. In ESCC cell lines with EGFR high expression, PD-L1 expression was induced significantly when EGFR signaling was activated by radiation and was dramatically inhibited by an EGFR tyrosine kinase inhibitor. In conclusion, tumor-infiltrating immune cell PD-L1 expression is an independent prognostic factor for ESCC, and the association between EGFR and PD-L1 is vital to determining survival. It is important to consider radiotherapy-induced imbalance of pro-tumor and anti-tumor immune response. A combination of radiotherapy and PD-L1-targeted therapy could be a promising therapeutic strategy for ESCC patients.
程序性死亡配体1(PD-L1)的表达要么表明免疫抑制状态,要么表明同时存在的免疫反应。尽管近年来PD-L1与临床结局之间的关系已得到广泛研究,但其在食管鳞状细胞癌(ESCC)预后中的作用仍不清楚。在此,我们评估了PD-L1在ESCC中的意义及其与表皮生长因子受体(EGFR)和放射反应的关联。我们发现PD-L1既存在于肿瘤细胞表面,也存在于肿瘤浸润免疫细胞表面。肿瘤浸润免疫细胞PD-L1表达的患者生存情况更好。免疫细胞上的PD-L1表达是ESCC患者的独立预后因素。肿瘤浸润免疫细胞或肿瘤细胞上的PD-L1表达与EGFR表达呈负相关。EGFR/PD-L1配对可以区分EGFR低/PD-L1阳性组和EGFR高/PD-L1阴性组之间的生存情况。在EGFR高表达的ESCC细胞系中,当辐射激活EGFR信号时,PD-L1表达显著诱导,而EGFR酪氨酸激酶抑制剂可显著抑制其表达。总之,肿瘤浸润免疫细胞PD-L1表达是ESCC的独立预后因素,EGFR与PD-L1之间的关联对于确定生存至关重要。考虑放疗诱导的促肿瘤和抗肿瘤免疫反应失衡很重要。放疗与PD-L1靶向治疗联合可能是ESCC患者一种有前景的治疗策略。