Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Pathology Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Acta Ophthalmol. 2019 May;97(3):e390-e396. doi: 10.1111/aos.13833. Epub 2018 Jun 4.
A limited number of therapies are available for patients with metastatic eyelid sebaceous carcinoma (SC). Programmed death receptor Ligand 1 (PD-L1) expression and its clinical significance in sebaceous cell carcinoma are presently unknown. This study aimed to evaluate the expression level of PD-L1 in SC.
This single centre, retrospective, and comparative study was conducted at the Ninth People's Hospital between August 1, 2013 and September 1, 2016. Twenty primary, 11 recurrent, and 10 lymph node metastatic eyelid SCs of 41 consecutive patients and paired control eyelid samples were enrolled in the study. Immunohistochemical staining of PD-L1 was performed on slides containing SC embedded in paraffin wax. Patient clinical characteristics and PD-L1 expression related to SC prognostic values were evaluated.
Of the 41 patients with eyelid SCs, 58.5% (24/41) were female, and 41.5% (17/41) were male. A total of 43.9% (18/41) were left-sided, and 56.1% (23/41) were right-sided. A total of 2.4% (1/41) of the SCs were located at the canthus, 51.2% (21/41) were located at the upper eyelid, 41.5% (17/41) were located at the lower eyelids, and 2.4% (1/41) invaded the lacrimal sac. A total of 24.4% of the SCs were metastatic (10/41), 48.8% (20/41) were primary tumours, and 26.8% (11/41) resulted from recurrence. A total of 48.8% (20/41) were moderately graded and 51.2% (21/41) were poorly graded. Programmed death receptor Ligand 1 (PD-L1) positive expression was found in 20 (48.8%) cases. Programmed death receptor Ligand 1 (PD-L1) expression was observed on the tumour cell membrane. Higher expression of PD-L1 was correlated with metastatic cases when compared with primary cases (F = 6.69, p = 0.001). There was a higher expression of PD-L1 in the poorly differentiated group compared with the moderately graded group (57.1% poorly graded versus 45.0% moderately graded).
Inhibition of PD-L1 expression may be a therapeutic option for metastatic eyelid SCs, although this hypothesis needs to be tested in future clinical trials.
转移性眼睑皮脂腺癌（SC）患者可用的治疗方法有限。目前尚不清楚程序性死亡受体配体 1（PD-L1）在皮脂腺癌中的表达及其临床意义。本研究旨在评估 SC 中 PD-L1 的表达水平。
本研究为 2013 年 8 月 1 日至 2016 年 9 月 1 日在第九人民医院进行的单中心回顾性比较研究。纳入了 41 例连续患者的 20 例原发性、11 例复发性和 10 例淋巴结转移性眼睑 SC 及配对的眼睑对照样本。将包含石蜡包埋 SC 的载玻片进行 PD-L1 的免疫组织化学染色。评估患者的临床特征和与 SC 预后价值相关的 PD-L1 表达。
41 例眼睑 SC 患者中，58.5%（24/41）为女性，41.5%（17/41）为男性。总共有 43.9%（18/41）位于左侧，56.1%（23/41）位于右侧。SC 总共有 2.4%（1/41）位于眼角，51.2%（21/41）位于上眼睑，41.5%（17/41）位于下眼睑，2.4%（1/41）侵犯泪囊。转移性 SC 总共有 24.4%（10/41），原发性肿瘤总共有 48.8%（20/41），复发总共有 26.8%（11/41）。中等级别总共有 48.8%（20/41），低级别总共有 51.2%（21/41）。PD-L1 阳性表达在 20 例（48.8%）病例中被发现。PD-L1 表达在肿瘤细胞膜上。与原发性病例相比，转移性病例的 PD-L1 表达更高（F=6.69，p=0.001）。与中等级别相比，低分化组 PD-L1 表达更高（57.1%低分化组与 45.0%中等级别）。
抑制 PD-L1 表达可能是转移性眼睑 SC 的治疗选择，尽管这一假设需要在未来的临床试验中进行检验。
